Individual provider Active NPI

Derek L Passer, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1174055693
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A182607 Issued in CA
Practice address
3626 Ruffin Rd
San Diego, CA 92123-1810
Phone
(858) 565-9666
Fax
(858) 565-9441
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD61505577 WA
Anesthesiology Physician 207L00000X 101829 WI
Anesthesiology Physician 207L00000X A182607 CA Primary
Anesthesiology Physician 207L00000X DR.0065803 CO

Addresses

Primary practice location

3626 Ruffin Rd
San Diego, CA 92123-1810

Mailing address

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (858) 565-9666

Other practice location 1

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 985-6403

Other practice location 2

2116 Craig Rd
Eau Claire, WI 54701-6118
Phone (715) 858-4610

Other identifiers 1

IdentifierTypeStateIssuer
2280216MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dpasser853305@fhsce.catholichealth.net Direct Franciscan Medical Group
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, OR, WI, NE, NY5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20240401001813 MT Practitioner - Anesthesiology 9830435585 Reassigns benefits to 1 organization
I20240619001524 OR Practitioner - Anesthesiology 9830435585 Reassigns benefits to 1 organization
I20241009000299 WI Practitioner - Anesthesiology 9830435585 Reassigns benefits to 9 organizations
I20250625001047 NE Practitioner - Anesthesiology 9830435585 Reassigns benefits to 1 organization
I20251024003122 NY Practitioner - Anesthesiology 9830435585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Rhinelander and Tomahawk Hospitals and Clinics, Inc.Group PAC ID 9335059856, shared by 17 NPIs, 566 clinicians
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7750

515 Main St
Olean, NY 14760-1513
Phone (716) 323-6570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A182607CAMDAnesthesiology Physician
DR.0065803COMDAnesthesiology Physician
MD61505577WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 1, 2024 Accepting new patients
Billings Clinic CurrentSince Apr 22, 2024 Accepting new patients
Bryan Hospital Kearney Anesthesiology CurrentSince May 1, 2025 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 1, 2024 Accepting new patients
Great Lakes Anesthesiology, PC CurrentSince Sep 1, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince May 28, 2025 Accepting new patients
MCHS Hospitals Inc Anesthesiology CurrentSince Oct 1, 2024 Accepting new patients
Billings Clinic Current Accepting new patients
Hospitalist Medicine Physicians of Washington - TCS Anesthesiology CurrentSince Jun 4, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 1, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 1, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 1, 2024 Accepting new patients
U S Anesthesia Partners of Montana P C Anesthesiology CurrentSince Mar 15, 2024 Accepting new patients
Bryan Hospital Kearney CurrentSince May 1, 2025 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince May 28, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 1, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 1, 2024 Accepting new patients
Billings Clinic CurrentSince Apr 22, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

816 22nd Ave
Ste 100
Kearney, NE 68845
Phone (308) 865-2263

804 22nd Ave
Kearney, NE 68845
Phone (308) 455-3600

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

515 Main St
Olean, NY 14760
Phone (716) 373-2600

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1000 N Oak Ave
Fl 2
Marshfield, WI 54449

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: dpasser853305@fhsce.catholichealth.net
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1174055693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-985-6403",
            "fax_number": "253-985-6879",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASSER",
        "first_name": "DEREK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD61505577",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "101829",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A182607",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0065803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2280216",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpasser853305@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1717 S J St # MS 20-15",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2116 Craig Rd",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.