DEREK J PEACOCK (MD) – Rheumatology Physician, NPI 1720085038

DEREK J PEACOCK (MD) is a healthcare provider. based in Richland, Washington. specializing in RHEUMATOLOGY, INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. MD00036578 (WA). The NPI Number for DEREK J PEACOCK (MD) is 1720085038

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
DEREK J PEACOCK (MD)
NPI
1720085038
Phone
(509) 940-2284
Address
1305 FOWLER ST STE 1D
Enumeration Date
30 June 2005
Last Update Date
18 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5095281866
Graduation Year
1981 (45 years ago)
PAC ID
7416949318
Group Practice PAC ID
0840781944
Professional Enrollment ID
I20100921000101
Address ID
WA993524719RI1305XSTXX304

Contacts

Secure Messaging
dpeacock1108630@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness95
Years active:20State licenses:1Other names

167 RHEUMATOLOGY in WA

Provider Addresses for DEREK J PEACOCK (MD)

  • 1305 FOWLER ST STE 1D

    RICHLAND, WA 993524719

    Phone: (509) 940-2284

    Type: Location

  • 560, Gage Boulevard, Tri-Cities, Benton County, Washington, 99352, United States

    STE 203

    RICHLAND, WA 99352

    Phone: (509) 942-3627

    Fax: (509) 942-2268

    Type: Mailing

  • 6710, West Okanogan Place, Tri-Cities, Benton County, Washington, 99336, United States

    KADLEC CLINIC RHEUMATOLOGY

    KENNEWICK, WA 99336

    Phone: (509) 942-2528

    Fax: (509) 783-2008

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100921000101IRheumatologyWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99352)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840781944View full group profile
NameSpecialtyState
Nurse PractitionerWA
Physician AssistantWA

Reviews

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Frequently asked questions

Does DEREK J PEACOCK (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DEREK J PEACOCK (MD) uses 1720085038.
Is DEREK J PEACOCK (MD) listed as active for patients and plans?
The listing shows DEREK J PEACOCK (MD) as active in the NPI system.
What taxonomy line describes DEREK J PEACOCK (MD)?
For research purposes, treat DEREK J PEACOCK (MD) as Rheumatology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DEREK J PEACOCK (MD)?
DEREK J PEACOCK (MD)'s geographic hint is Richland, Washington in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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