Active NPI
Derrick Lamar Reedus Sr., M.D.
- Urology Physician
- Newark, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35.090640
- Practice address
- 1980 Tamarack Rd
Newark, OH 43055-1363 - Phone
- (220) 564-7520
- Fax
- (220) 564-7521
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 35.090640 | OH | Primary |
Addresses
Primary practice location
1980 Tamarack Rd
Newark, OH 43055-1363
Mailing address
1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4027
Other practice location 1
4000 Miamisburg Centerville Rd Ste 450
Miamisburg, OH 45342-3908
Phone (937) 560-2011
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dreedus25199@lickingmemorial.medicity.net | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ | ||
| Direct Messaging Address | dreedus891417@direct.ketteringhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Northeastern Ohio University College of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4000 Miamisburg Centerville Rd
Suite 450
Miamisburg, OH 45342-3908
Phone (937) 560-2011
751 Forest Ave
Suite 301
Zanesville, OH 43701-2875
Phone (740) 454-0804
Hospital & facility affiliations
- Genesis Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.98 of 100
- Quality
- 75.66
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.38
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.090640 | OH | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Medical Group, LLC | Current | Accepting new patients | |
| Genesis Medical Group LLC | Current | Accepting new patients | |
| Kettering Independent Medical Group Inc | Current | Accepting new patients | |
| Alliance Physicians Inc | Current | Accepting new patients | |
| Adena Medical Group LLC | Urology | Past | Accepting new patients |
| Licking Memorial Professional Corp. | Past | Accepting new patients |
Locations
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600
945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038
751 Forest Ave
Ste 301
Zanesville, OH 43701
Phone (740) 454-0804
Organizations & group practices 6
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.
-
- General Practice Physician
- Zanesville, OH
- NPI 1063663433
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
-
- Family Medicine Physician
- Kettering, OH
- NPI 1437125572
-
- Durable Medical Equipment & Medical Supplies
- Coshocton, OH
- NPI 1144022187
-
- Pediatrics Physician
- Utica, OH
- NPI 1497771521
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Zanesville, OH
- NPI 1598868655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1194929463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 W MAIN ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551822",
"telephone_number": "220-564-4027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 TAMARACK RD",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551363",
"telephone_number": "220-564-7520",
"fax_number": "220-564-7521"
}
],
"practiceLocations": [
{
"address_1": "4000 Miamisburg Centerville Rd Ste 450",
"address_purpose": "LOCATION",
"city": "Miamisburg",
"state": "OH",
"postal_code": "453423908",
"country_code": "US",
"telephone_number": "937-560-2011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REEDUS",
"first_name": "DERRICK",
"middle_name": "LAMAR",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OH",
"license": "35.090640",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dreedus25199@lickingmemorial.medicity.net",
"affiliation": "N",
"address_1": "1980 Tamarack Rd",
"city": "Newark",
"state": "OH",
"country_code": "US",
"postal_code": "430551363",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 450",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453423908",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dreedus891417@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 450",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453423908",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.