Derrick Bieller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12666 Issued in NC

Practice address

1340 Walter Reed Rd Ste 202
Fayetteville, NC 28304-4451

Phone

(910) 504-3506

Fax

(910) 504-3507

NPI assigned

Nov 26, 2018

Last updated

Oct 1, 2025By the provider in NPPES

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 NC, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Recon Neurology and PsychiatryGroup PAC ID 3870965924, 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBCJCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Recon Neurology & Psychiatry

  • Neurology Physician
  • Fayetteville, NC
  • NPI 1427769140
  Medicare reassignment Care Compare group NPD
• Brighter Days Psychiatric Wellness Care LLC

  • Psychiatry Physician
  • Sanford, NC
  • NPI 1972490720
  Medicare reassignment NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1063982734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 WALTER REED RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044451",
            "telephone_number": "910-504-3506",
            "fax_number": "910-504-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 WALTER REED RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044451",
            "telephone_number": "910-504-3506",
            "fax_number": "910-504-3507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Carthage St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273304114",
            "country_code": "US",
            "telephone_number": "919-463-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIELLER",
        "first_name": "DERRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhlea Biomed Inc
• Iqbal Bhuiyan, NP
• Bianca K. Adams, DMD & Associates, P.C.
• Biblical Counseling Services
• Megan H Bickel, LPC
• Stephanie J Bielli, LPN, IBCLC
• Megan Canavera Bies, MS, RD, LDN
• Big Dreamers Youth on the Rise PLLC
• Adam Biggerstaff
• Anas Bilal, MD

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.