Derek McCalla

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A161942 Issued in CA

Practice address

11234 Anderson Street
Loma Linda University Health-Transitional Year
Loma Linda, CA 92354-2804

Phone

(909) 558-6491

NPI assigned

May 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmccalla81370@direct.llu.edu

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.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • San Bernardino, CA
  • NPI 1124077516
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935915
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  NPD
• Community Hospital of San Bernardino

  • Pediatric Skilled Nursing Facility
  • San Bernardino, CA
  • NPI 1851395685
  NPD (past)
• Loma Linda University Children'S Hospital

  • Children's Hospital
  • Loma Linda, CA
  • NPI 1366866345
  NPD (past)
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)
• Diagnostic Imaging Services

  • Magnetic Resonance Imaging (MRI) Internal Medicine Physician
  • Metairie, LA
  • NPI 1699793166
  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417484437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS STREET COLEMAN PAVILION SUITE A1121",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET",
            "address_2": "LOMA LINDA UNIVERSITY HEALTH-TRANSITIONAL YEAR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLA",
        "first_name": "DEREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A161942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robynn Mays
• Mazna Ahmad MD Inc
• Sarah H Mazumder, PHARMD
• Barry Alan McBride, MSW
• Melissa D McCabe, MD, MSCR
• Kyle F McCallin, D.O.
• Frances Rowena McCann, ACNP
• Dennis S McCarty, R.R.T.
• Zachary McCarty, MD
• Daniel R McClellan, DO

• Pediatrics Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.