Individual provider Active NPI

Derek Oliver

  • Physician Assistant
  • Ventura, CA
National Provider Identifier
1386153237
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54952 Issued in CA
Practice address
300 Hillmont Ave
Ventura, CA 93003-1651
Phone
(805) 652-6000
NPI assigned
Sep 22, 2017
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 54952 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
Ventura, CA 93003-1651

Mailing address

PO Box 1108
Thousand Oaks, CA 91358-0108
Phone (805) 300-1242

Other practice location 1

133 W Santa Clara St
Ventura, CA 93001-2543
Phone (805) 641-5600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derek.oliver@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103002598 CA Practitioner - Physician Assistant 8123384369 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54952CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince May 1, 2025 Accepting new patients
Cep America - California CurrentSince Oct 1, 2017 Accepting new patients
Cep America-California CurrentSince Oct 1, 2017 Accepting new patients
County of Ventura CurrentSince May 1, 2025 Accepting new patients
County of Ventura Current Accepting new patients

Locations

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

825 N 10th St
Santa Paula, CA 93060
Phone (805) 933-8600

133 W Santa Clara St
Ventura, CA 93001
Phone (805) 641-5600

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Interoperability endpoints

  • Direct secure messaging: derek.oliver@ventura.cernerdirect.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1386153237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913580108",
            "telephone_number": "805-300-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 W Santa Clara St",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930012543",
            "country_code": "US",
            "telephone_number": "805-641-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derek.oliver@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "133 W Santa Clara St",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930012543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.