Individual provider Active NPI

Derek John Hiltz, DO

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1366494742
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S9333 Issued in FL
Practice address
1505 53Rd Ave E
Bradenton, FL 34203-4249
Phone
(941) 357-7950
Fax
(941) 840-1003
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0S9333 FL Primary

Addresses

Primary practice location

1505 53Rd Ave E
Bradenton, FL 34203-4249

Mailing address

508 Pasadena Ave S Ste 501
St Petersburg, FL 33707-2126
Phone (727) 343-6119

Other identifiers 1

IdentifierTypeStateIssuer
278578100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000116 FL Practitioner - Family Practice 7315971553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

508 Pasadena Ave S
Optum Pasadena
St Petersburg, FL 33707-2126
Phone (727) 343-6119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S9333FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jan 1, 2026 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jan 1, 2026 Accepting new patients
Optumcare Florida LLC Family Medicine CurrentSince Jul 2, 2007 Accepting new patients
Optumcare Florida, LLC CurrentSince Jul 2, 2007 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC Past Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1505 53rd Ave E
Bradenton, FL 34203
Phone (941) 357-7950

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

508 Pasadena Ave S
Ste 501
St Petersburg, FL 33707

508 Pasadena Ave S
St Petersburg, FL 33707
Phone (727) 343-6119

Interoperability endpoints

  • Direct secure messaging: derek.hiltz@wellmed.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1366494742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PASADENA AVE S STE 501",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337072126",
            "telephone_number": "727-343-6119",
            "fax_number": "727-345-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034249",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILTZ",
        "first_name": "DEREK",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0S9333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278578100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.