NPIMap

Individual provider Active NPI

Thomas A Derby Jr., DO

  • Diagnostic Radiology Physician
  • Reno, NV
National Provider Identifier
1447719430
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DO3918 Issued in NV
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Mar 18, 2019
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DO3918 NV Primary

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

1555 Rusty Ridge LN
Henderson, NV 89002-9390
Phone (775) 997-6200

Other practice location 1

9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903
Phone (702) 916-6904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210609001202 NE Practitioner - Emergency Medicine 8426384819 Reassigns benefits to 3 organizations
I20250724002439 NV Practitioner - Diagnostic Radiology 8426384819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.27 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2316NEMDProfessional Counselor
DO3918NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Current Accepting new patients
Jennie M Melham Memorial Medical Center Inc Current Accepting new patients
Community Care Services LLC CurrentSince Aug 1, 2025 Accepting new patients
Avera St Anthonys Hospital Current Accepting new patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Sep 3, 2021 Accepting new patients
Community Care Services LLC Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients

Locations

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1447719430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 RUSTY RIDGE LN",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890029390",
            "telephone_number": "775-997-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9260 W Sunset Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891484903",
            "country_code": "US",
            "telephone_number": "702-916-6904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERBY",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "DO3918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.