Derick Wayne Rias, RPAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002394 Issued in NY

Practice address

18361 Elmira Ave
Saint Albans, NY 11412-1515

Phone

(718) 454-3962

NPI assigned

Oct 18, 2010

Sex

Male

Sole proprietor

Yes

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 NY

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 1

Medicare enrollment (NPD)

Enrolled

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.

• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  Medicare reassignment NPD
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1083924500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18361 ELMIRA AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114121515",
            "telephone_number": "718-454-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18361 ELMIRA AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114121515",
            "telephone_number": "718-454-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIAS",
        "first_name": "DERICK",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "RPAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dionne Raymond
• Nhaomi Raymond
• Marie Reid Robinson
• Nadege Imani Reid
• Gina Rene
• Toye Roberta Richardson-Brown
• Lorena B Rios, P.T.
• Dashanae Stephanie Roberts, RN
• Millicent R Roberts, LPN
• Louise Robillard

• Physician Assistant in Saint Albans, NY
• Providers in Saint Albans, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.

Verify at the official NPI Registry.