Richard Derby Jr., MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

G24348 Issued in CA

Practice address

901 Campus Drive
Suite 312
Daly City, CA 94015

Phone

(650) 755-0733

Fax

(650) 755-3018

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Spinal Diagnostics & Treatment Center

  • Ambulatory Surgical Clinic/Center
  • Daly City, CA
  • NPI 1417992835
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1013008481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DRIVE",
            "address_2": "SUITE 312",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-755-0733",
            "fax_number": "650-755-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DRIVE",
            "address_2": "SUITE 312",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-755-0733",
            "fax_number": "650-755-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G24348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF BOARD",
            "identifier": "G24348",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alysiamay F Delos Reyes
• Anna Lyn Delos Santos
• Toshie Dempsey, NP
• Stephan Denis
• Dennis L. Hamby, MD
• Priya Mehul Desai
• Rodolfo Reyes Deza, D.D.S.
• Nicholas Diak
• Jennifer J. Diehn, MD
• Selena Diep

• Pain Medicine (Anesthesiology) Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.