Individual provider Active NPI

Derekka Alyse Ybarra

  • Nurse Practitioner
  • Miami, OK
National Provider Identifier
1104336536
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
113409 Issued in OK
Practice address
30 B St SW
Miami, OK 74354-6808
Phone
(918) 542-2273
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2020036159 MO
Nurse Practitioner 363L00000X 113409 OK Primary

Addresses

Primary practice location

30 B St SW
Miami, OK 74354-6808

Mailing address

PO Box 3810
Joplin, MO 64803-3810

Other practice location 1

1510 Elmwood Cir
Miami, OK 74354-1405
Phone (918) 541-6740

Other practice location 2

200 2nd Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

Other practice location 3

1102 W 32nd St
Joplin, MO 64804-3503
Phone (417) 347-1111

Other practice location 4

3333 McIntosh Cir Ste 4
Joplin, MO 64804-3681
Phone (417) 347-5000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180326000290 OK Practitioner - Nurse Practitioner 8628330958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

30 B St SW
Miami, OK 74354-6808
Phone (417) 347-3649

Hospital & facility affiliations

  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2020036159MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Oct 1, 2023 Accepting new patients
Emergency Services of Oklahoma PC Nurse Practitioner CurrentSince Apr 1, 2018 Accepting new patients
South Central Emergency Services PC Nurse Practitioner CurrentSince Apr 1, 2018 Accepting new patients
Freeman-Oak Hill Health System Current Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Oct 1, 2023 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Sep 1, 2020 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Sep 1, 2020 Accepting new patients

Locations

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

3333 McIntosh Cir
Ste 4
Joplin, MO 64804
Phone (417) 347-5000

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

1101 E 13th St
Grove, OK 74344
Phone (417) 347-3649

30 B St SW
Miami, OK 74354
Phone (918) 542-2273

2518 N Main St
Miami, OK 74354
Phone (918) 540-9077

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

2501 N 14th St
Ponca City, OK 74601
Phone (580) 749-5076

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1104336536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 B ST SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546808",
            "telephone_number": "918-542-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 Elmwood Cir",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "OK",
            "postal_code": "743541405",
            "country_code": "US",
            "telephone_number": "918-541-6740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 2nd Ave SW",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "OK",
            "postal_code": "743546830",
            "country_code": "US",
            "telephone_number": "918-542-6611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 W 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043503",
            "country_code": "US",
            "telephone_number": "417-347-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 McIntosh Cir Ste 4",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043681",
            "country_code": "US",
            "telephone_number": "417-347-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YBARRA",
        "first_name": "DEREKKA",
        "middle_name": "ALYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020036159",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "113409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.