NPIMap

Individual provider Active NPI

Derek S. Palmer, MD

  • Surgical Critical Care Physician
  • Las Vegas, NV
National Provider Identifier
1407290372
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
322143 Issued in LA
Practice address
1707 W Charleston Blvd Ste 160
Las Vegas, NV 89102-2354
Phone
(702) 671-5150
NPI assigned
Apr 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26665 MS
Surgery Physician 208600000X 313121 LA
Surgical Critical Care Physician 2086S0102X 322143 LA Primary

Addresses

Primary practice location

1707 W Charleston Blvd Ste 160
Las Vegas, NV 89102-2354

Mailing address

101 Judge Tanner Blvd Ste 300
Covington, LA 70433-7506
Phone (985) 888-8750

Other practice location 1

101 Judge Tanner Blvd Ste 300
Covington, LA 70433-7506
Phone (985) 888-8750

Other practice location 2

15770 Paul Vega Md Dr Ste 108A
Hammond, LA 70403-1475
Phone (985) 230-1870

Other identifiers 2

IdentifierTypeStateIssuer
2332171MedicaidLA
322143OtherLANORTH OAKS MEDICAL CENTER / PHYSICIAN GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200602001042 LA Practitioner - General Surgery 2769788736 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Jefferson Physicians Group LLCGroup PAC ID 4587660402, 211 clinicians
North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians

Practice addresses (Care Compare)

101 Judge Tanner Blvd
Suite 300
Covington, LA 70433-7506
Phone (985) 867-2100

15770 Paul Vega MD Dr
Suite 108a
Hammond, LA 70403-1475
Phone (985) 230-1870

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • North Oaks Medical Center Hospital, Hammond, LA, CCN 190015
  • Riverside Medical Center Hospital, Franklinton, LA, CCN 191313

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322143LAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Jefferson Physicians Group LLC CurrentSince Mar 1, 2023 Accepting new patients
University Medical Center Management Corporation Surgery CurrentSince Aug 17, 2020 Accepting new patients
North Oaks Medical Center, LLC CurrentSince Nov 12, 2023 Accepting new patients
University Medical Center Management Corporation CurrentSince Aug 17, 2020 Accepting new patients
North Oaks Physician Group, LLC CurrentSince Nov 12, 2023 Accepting new patients
North Oaks Physician Group, LLC CurrentSince Nov 12, 2023 Accepting new patients
Metairie Physician Services Inc. Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

101 Judge Tanner Blvd
Ste 300
Covington, LA 70433
Phone (985) 888-8750

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

15813 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 230-7650

15770 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-7860

15770 Paul Vega Md Dr
Ste 108A
Hammond, LA 70403
Phone (985) 230-1870

4320 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4109

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4228 Houma Blvd
Ste 530
Metairie, LA 70006
Phone (504) 456-8415

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1407290372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 JUDGE TANNER BLVD STE 300",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337506",
            "telephone_number": "985-888-8750",
            "fax_number": "985-888-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022354",
            "telephone_number": "702-671-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Judge Tanner Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704337506",
            "country_code": "US",
            "telephone_number": "985-888-8750",
            "fax_number": "985-888-8760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15770 Paul Vega Md Dr Ste 108A",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704031475",
            "country_code": "US",
            "telephone_number": "985-230-1870",
            "fax_number": "985-230-1871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "DEREK",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "26665",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "313121",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "LA",
            "license": "322143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2332171",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH OAKS MEDICAL CENTER / PHYSICIAN GROUP",
            "identifier": "322143",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.