Derick E Vergne, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

249376 Issued in MA

Practice address

179 Great Rd Ste 201
Acton, MA 01720-5774

Phone

(857) 239-1911

Fax

(617) 544-0937

NPI assigned

Jan 9, 2007

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Psychiatry

Education

University of Puerto Rico School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Derick E. Vergne, MD PLLC

  • Psychiatry Physician
  • Acton, MA
  • NPI 1003536798
  Medicare reassignment NPD Authorized official
• Derick E. Vergne MD, PLLC

  • Psychiatry Physician
  • Acton, MA
  • NPI 1033847595
  NPD Authorized official

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1013066083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 GREAT RD",
            "address_2": "STE 201",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205774",
            "telephone_number": "857-239-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 GREAT RD STE 201",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205774",
            "telephone_number": "857-239-1911",
            "fax_number": "617-544-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGNE",
        "first_name": "DERICK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "249376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asli Unver
• Susan Valente, LICSW
• Alicia Valerio
• Vanessa Demelo
• Jenna Venooker
• Deborah Verner
• Jamie Vetterli
• Diana L Villegas, LICSW
• Rachel Vinicor
• Agnes Virga, M. D.

• Psychiatry Physician in Acton, MA
• Providers in Acton, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.

Verify at the official NPI Registry.