Robert John Derby, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11369-33 Issued in WI

Practice address

Beloit Clinic
1905 E Huebbe Parkway
Beloit, WI 53511-1842

Phone

(608) 364-1640

Fax

(608) 363-7393

NPI assigned

Aug 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100

Merit-based Incentive Payment System (MIPS)

Final score

80.93 of 100Reported as group

Quality

64.82

Promoting interoperability

100

Improvement activities

40

Cost

71.63

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Beloit Health System Inc

  • General Practice Physician
  • Beloit, WI
  • NPI 1679616361

  WI

  Medicare reassignment NPD
• Beloit Health System Inc

  • General Practice Physician
  • Roscoe, IL
  • NPI 1841485984

  IL

  Medicare reassignment NPD
• Beloit Clinic, S.C.

  • Internal Medicine Physician
  • Beloit, WI
  • NPI 1548345887
  NPD
• Beloit Health System, Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Beloit, WI
  • NPI 1568677417
  NPD
• Beloit Health System, Inc

  • Family Medicine Physician
  • Janesville, WI
  • NPI 1407999337
  NPD (past)

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

• Beloit Health System Inc

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1104593060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEMS INC",
            "address_2": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-2293",
            "fax_number": "608-364-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BELOIT CLINIC",
            "address_2": "1905 E HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-1640",
            "fax_number": "608-363-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-12-04",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024153",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11369-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11369-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iain W. Decker, DO
• Judy Ann Decker
• Karla J. Degarmo-Haakenson, LCSW
• Emily C Dempsey, NP
• Martin Densch, RPH
• Chitra Desai, M.D.
• Prachi Rakesh Desai, DMD
• Sanjay S Deshpande, M.D.
• Alan John Dickman
• Steven E Diebold, MD

• Nurse Practitioner in Beloit, WI
• Providers in Beloit, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.