Active NPI
Derek Titus
- Family Medicine Physician
- Pullman, WA
National Provider Identifier
1013505684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO.OP.70131936
- Practice address
- 1125 SE Washington St Pullman Wa 99164
Pullman, WA 99164-0001 - Phone
- (509) 335-3575
- NPI assigned
- Jan 8, 2021
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO.OP.70131936 | WA | Primary |
Addresses
Primary practice location
1125 SE Washington St Pullman Wa 99164
Pullman, WA 99164-0001
Mailing address
624 E Front Ave
Spokane, WA 99202-2139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240126000269 | WA | Order and Referring Only - Family Practice | 7012360050 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1013505684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 E FRONT AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992022139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 SE WASHINGTON ST PULLMAN WA 99164",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991640001",
"telephone_number": "509-335-3575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITUS",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-08",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "DO.OP.70131936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pullman, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.