Active NPI
Derick Thomas, PA-C
- Physician Assistant
- Paducah, KY
National Provider Identifier
1003339920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2242
- Practice address
- 2603 Kentucky Ave Ste 102
Paducah, KY 42003-3815 - Phone
- (270) 228-3973
- Fax
- (270) 359-5046
- NPI assigned
- Jul 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2242 | KY | Primary |
Addresses
Primary practice location
2603 Kentucky Ave Ste 102
Paducah, KY 42003-3815
Mailing address
2603 Kentucky Ave Ste 102
Paducah, KY 42003-3815
Phone (270) 228-3973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2603 Kentucky Ave
Suite 102
Paducah, KY 42003-3815
Phone (270) 228-3973
Hospital & facility affiliations
- Baptist Health Paducah
- Murray-Calloway County Hospital
- Jackson Purchase Medical Center
- Massac Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 62.45 of 100
- Quality
- 50.17
- Promoting interoperability
- 100
- Improvement activities
- 0
- Cost
- 74.66
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2242 | KY | MD | Physician Assistant |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/3979aec0-01c5-4867-872c-320311ff1822/
- derick.thomas.p1@direct.strengespine.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Paducah, KY
- NPI 1497425177
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paducah, KY
- NPI 1730264128
-
- General Acute Care Hospital
- Murray, KY
- NPI 1073504981
-
- Rural Acute Care Hospital
- Mayfield, KY
- NPI 1891892741
-
- Critical Access Hospital
- Metropolis, IL
- NPI 1790788578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1003339920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2603 KENTUCKY AVE STE 102",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420033815",
"telephone_number": "270-228-3973",
"fax_number": "270-359-5046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2603 KENTUCKY AVE STE 102",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420033815",
"telephone_number": "270-228-3973",
"fax_number": "270-359-5046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "DERICK",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-23",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA2242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.