DERBY DERM – Physician Assistant, NPI 1871771998

DERBY DERM is a healthcare provider. based in Derby, Kansas. specializing in Physician Assistant. The organization holds a License No. 1500761 (KS). The NPI Number for DERBY DERM is 1871771998

Main info

Organization
Name
DERBY DERM
NPI
1871771998
Phone
(316) 788-3376
Address
1121 N COLLEGE PARK ST
Authorized Official
MR. TIM WEIDE PRESIDENT P.A.
Enumeration Date
31 January 2008
Last Update Date
31 January 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for DERBY DERM

  • Park Street, Castleward, Pride Park, Derby, East Midlands, England, DE1 2NB, United Kingdom

    SUITE # 400

    DERBY, KS 670373665

    Phone: (316) 788-3376

    Fax: (316) 788-3378

    Mailing address matches the actual address.

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: 2009-06-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-05-31 (744 days ago).

Enrollment records

1

Earliest due date

2024-05-31

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
O20090601000544OClinic/Group PracticeKS2024-05-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 67037)

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Reviews

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Frequently asked questions

What is DERBY DERM's NPI number?
DERBY DERM's NPI is 1871771998 — the number used across U.S. healthcare to identify this provider.
Is DERBY DERM still an active registrant?
DERBY DERM carries an active NPI according to the public dataset.
How would a patient describe DERBY DERM's focus?
For DERBY DERM, the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with DERBY DERM?
Directory geography for DERBY DERM centers on Derby, Kansas.
When was this NPI issued?
Enumeration for DERBY DERM is noted as January 31, 2008 where the registry provides it.

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