Individual provider Active NPI

Derek R Linklater, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Fort Hood, TX
National Provider Identifier
1043296122
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
L7799 Issued in TX
Practice address
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Phone
(254) 493-4472
Fax
(512) 710-1314
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L7799 TX
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X L7799 TX
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X L7799 TX Primary

Addresses

Primary practice location

36065 Santa Fe Ave
Fort Hood, TX 76544-5060

Mailing address

2205 Ravenhill Cir
Belton, TX 76513-1307
Phone (254) 493-4472

Other practice location 1

6621 Fannin St
Houston, TX 77030-2358
Phone (832) 824-1000

Other identifiers 3

IdentifierTypeStateIssuer
164777801MedicaidTX
164764604MedicaidTX
8C0840OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040601000525 TX Practitioner - Emergency MedicinePractitioner - Other (Physician) 3779564141 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Feb 2, 2023 Accepting new patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Jul 15, 2017 Accepting new patients
Premier Physicians-II, P.a. CurrentSince Apr 1, 2017 Accepting new patients
Brazos Valley Emergency Physicians PA Emergency Medicine Past Accepting new patients
Neptune Emergency Services, P.a. Emergency Medicine Past Accepting new patients
Texas Childrens Hospital Past Accepting new patients
Texas Children'S Hospital Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12201 Renfert Way
Ste 110
Austin, TX 78758
Phone (512) 491-5125

1102 Bates Ave
#1450
Houston, TX 77030

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

18220 Tomball Pkwy
Houston, TX 77070
Phone (281) 477-0000

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

900 Austin Ave
Ste 1001
Waco, TX 76701
Phone (254) 224-8808

9110 Jordan Ln
Ste 100
Woodway, TX 76712
Phone (254) 399-0740

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1043296122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 RAVENHILL CIR",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765131307",
            "telephone_number": "254-493-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-493-4472",
            "fax_number": "512-710-1314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302358",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINKLATER",
        "first_name": "DEREK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L7799",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "L7799",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "L7799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164777801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164764604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8C0840",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.