Individual provider Active NPI

Melody Joy Derrick, M.D.

  • Family Medicine Physician
  • Winfield, IL
National Provider Identifier
1407945827
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-114979 Issued in IL
Practice address
25 N Winfield Rd
Winfield, IL 60190-1295
Phone
(630) 260-0600
Fax
(630) 260-1370
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 036-114979 IL Primary

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1295

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 260-0600

Other identifiers 2

IdentifierTypeStateIssuer
P00386296OtherILRR MEDICARE (INDIVIDUAL)
036114979MedicaidIL

Other names 1

  • Dr. Melody Joy Derrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20070315000086 IL Practitioner - Family Practice 6901909753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

25 N Winfield Rd
Winfield, IL 60190-1295

2900 Foxfield Rd
St Charles, IL 60174-5799

Hospital & facility affiliations

  • DMJ Home Health Services, Inc Home health agency, Aurora, IL, CCN 147997
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Marianjoy Rehabilitation Center Inpatient rehabilitation facility, Wheaton, IL, CCN 143027

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114979ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Mar 1, 2007 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Mar 1, 2007 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2900 Foxfield Rd
St Charles, IL 60174
Phone (630) 377-6500

1800 N Main St
#102
Wheaton, IL 60187

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1800 N Main St
Ste 102
Wheaton, IL 60187
Phone (630) 260-0600

25 N Winfield Rd
Ste 401
Winfield, IL 60190
Phone (630) 933-4200

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 3

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 9

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1407945827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-260-0600",
            "fax_number": "630-260-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-260-0600",
            "fax_number": "630-260-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "MELODY",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (INDIVIDUAL)",
            "identifier": "P00386296",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114979",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "DERRICK",
            "middle_name": "JOY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.