Derrek Davis, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Practice address

800 Biesterfield Rd
Dept of Anesthesia
Elk Grove Village, IL 60007-3311

Phone

(847) 495-1603

Fax

(847) 537-4866

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL, GA2 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 2

Specialty

Anesthesiology

Education

Loyola University of Chicago, Stritch School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Anesthesiology

  Medicare reassignment NPD
• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  IL

  Medicare reassignment NPD
• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  IL

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

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

• Piedmont Newton Hospital, Inc.

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306902606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-495-1603",
            "fax_number": "847-537-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-495-1603",
            "fax_number": "847-537-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DERREK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00206308",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096194 2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0161919966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Davenport, APN
• David J Schumer DDS PC
• Rafie Davidov, A.P.N.-C.N.P.
• Amy Davis, PHD
• Brittany Davis
• Jennifer Erin Davis, MSPT
• Raymond Edwin Davis
• Alexis De Gale, DVM
• Rayner De la Cruz Segura, PTA
• Yessenia De la O

• Anesthesiology Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.