Ryan Derrah

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

31328 Issued in NE

Practice address

36065 Santa Fe Ave
Fort Hood, TX 76544-5060

Phone

(503) 539-6893

NPI assigned

Aug 5, 2015

Last updated

Aug 19, 2020By 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 TX, OR2 enrollments

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 2

Specialty

Emergency Medicine

Education

Oregon Health Sciences University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medical Associates of McMinnvilleGroup PAC ID 3870585920, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071

Merit-based Incentive Payment System (MIPS)

Final score

98.83 of 100Reported as group

Quality

83.85

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medical Associates of McMinnville

  • Emergency Medicine Physician
  • McMinnville, OR
  • NPI 1629022876
  Medicare reassignment Care Compare group
• Legacy Urgent Care, PA

  • Urgent Care Clinic/Center
  • Frisco, TX
  • NPI 1568622272
  Medicare reassignment NPD
• Premier Physicians-II, P.a.

  dba Premier Urgent Care Plus

  • Urgent Care Clinic/Center
  • Woodway, TX
  • NPI 1801204656
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willamette Valley Medical Center LLC

  dba Willamette Valley Medical Center

  • General Acute Care Hospital
  • McMinnville, OR
  • NPI 1346269982
  Care Compare affiliation

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1083090625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 SOUTHERN CROSSING DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765027703",
            "telephone_number": "503-539-6893"
        },
        {
            "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": "503-539-6893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "984311000",
            "country_code": "US",
            "telephone_number": "253-968-2997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERRAH",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "31328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicollette Arneatha Dennis, LCSW
• Paul Raeford Dennis, PA-C
• Dentrust Dental Texas, P.C. (DOCS Ft. Hood)
• Department of the Army
• Emily L Derosa, PA
• Carolyn Shavon Desouza, LVN
• Lisa Ann Devito, RD
• Emmanuel Diaz Perez, M.D.
• Liliana Diaz Pla, PH.D.
• Daniel Robert Diblasi, D.O.

• Emergency Medicine Physician in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.