Individual provider Active NPI

Derek M West, ACNP-BC

  • Acute Care Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1164756664
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71003054A Issued in IN
Practice address
520 Mary St Ste 520
Evansville, IN 47710-1682
Phone
(812) 424-8231
Fax
(812) 435-8794
NPI assigned
Sep 30, 2009
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71003054A IN Primary

Addresses

Primary practice location

520 Mary St Ste 520
Evansville, IN 47710-1682

Mailing address

520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Other practice location 1

4133 Gateway Blvd Ste 290
Newburgh, IN 47630-7918
Phone (812) 424-8231

Other practice location 2

801 Saint Marys Dr Ste 200E
Evansville, IN 47714-0518
Phone (812) 424-8231

Other identifiers 4

IdentifierTypeStateIssuer
71003054AOtherININ LICENSE
7100101320MedicaidKY
000000637973OtherINANTHEM
200975230MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20091207000657 IN Practitioner - Nurse Practitioner 5092854810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evansville Surgical Associates IncGroup PAC ID 1557346723, 45 clinicians

Practice addresses (Care Compare)

520 Mary St
Suite 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
37.54 of 100Reported as group
Promoting interoperability
0
Improvement activities
40
Cost
65.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003054AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Nurse Practitioner Current Accepting new patients
Deaconess Specialty Physicians, Inc Nurse Practitioner CurrentSince Jul 15, 2019 Accepting new patients
Deaconess Specialty Physicians Inc Nurse Practitioner CurrentSince Jul 15, 2019 Accepting new patients

Locations

515 Read St
Evansville, IN 47710
Phone (812) 437-1420

520 Mary St
Ste 230
Evansville, IN 47710
Phone (812) 450-8600

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4007 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 842-0907

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1164756664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4133 Gateway Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307918",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Saint Marys Dr Ste 200E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140518",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "DEREK",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2026-09-29",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71003054A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN LICENSE",
            "identifier": "71003054A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100101320",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000637973",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.