Derek Mackenzie Holden

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1515 SW Archer Rd
Gainesville, FL 32608-1134

Phone

(352) 265-0111

NPI assigned

Jun 5, 2021

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 FL, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart and Vascular Center of Arizona, PLLCGroup PAC ID 3870487812, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

47.54 of 100Reported as apm

Quality

38.49

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.holden.1@33009.direct.athenahealth.com

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.

• Heart & Vascular Center of Arizona, PLLC

  • Cardiovascular Disease Physician
  • Phoenix, AZ
  • NPI 1255379541
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)

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

{
    "created_epoch": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622851200000",
    "number": "1457928848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 SW 27TH ST APT 20",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326087301",
            "telephone_number": "619-571-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081134",
            "telephone_number": "352-265-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "DEREK",
        "middle_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-06-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bella Rachel Hoins
• Makayla F Hoke, PHARMD
• Richard C. Holbert, MD
• Charise Holcombe, PA-C
• Latoya Holcy
• Kairstyn Kaye Holden, PHARMD
• Lashonda Holden
• Brittany Holder, RBT
• Jessica Rachael Holder, ARNP
• Jordan Holder

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.