Derick Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERICK DERMATOLOGY, PLLC

Practice address

10114 Gibsonton Dr
Riverview, FL 33578-5305

Phone

(847) 381-8899

NPI assigned

Nov 17, 2022

Last updated

Nov 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Jane Derick, MDNPI 1245279884

Title

Medical Director

Phone

(847) 381-8899

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Derick Dermatology, PLLC

  • Dermatology Physician
  • Tampa, FL
  • NPI 1396455861

  O20220719002623

  Same enrollment
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Tampa, FL
  • NPI 1568183465

  O20220719002623

  Same enrollment
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Wesley Chapel, FL
  • NPI 1861159675

  O20220719002623

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Jane Derick, M.D

  • Dermatology Physician
  • Barrington, IL
  • NPI 1245279884
  Authorized official Same address or phone
• Anndy Nguyen, PA-C

  • Physician Assistant
  • Wesley Chapel, FL
  • NPI 1396571832
  NPD
• John Derek Denigris IV, M.D.

  • Dermatology Physician
  • Wesley Chapel, FL
  • NPI 1174987259
  NPD (past)
• Abigail Katelyn Greiwe, PA-C

  • Physician Assistant
  • Wesley Chapel, FL
  • NPI 1134011141
  NPD (past)
• Donna Rosenfield, PA-C

  • Physician Assistant
  • Wesley Chapel, FL
  • NPI 1356138796
  NPD (past)

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1225747363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10114 GIBSONTON DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785305",
            "telephone_number": "847-381-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10114 GIBSONTON DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785305",
            "telephone_number": "847-381-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERICK DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "DERICK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-381-8899",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentists at Big Bend, PA
• Dentists of Riverview, PA (Dentists of Riverview)
• Leanne Kathryn Depa, OTR
• Kayla N Depanicis, PA-C
• Derek Espino, D.M.D. PA (Riverview Dental Arts)
• Shrina Desai, DO
• Supreet Deshmukh
• Janelle Stephanie Dessources
• Devenie Robbins Arnp LLC
• Dencie Janine Padilla Devora, DO

• Dermatology Physician in Riverview, FL
• Providers in Riverview, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.