Individual provider Active NPI

Derek Naegle, DPM

  • Podiatrist
  • Riverside, CA
National Provider Identifier
1467607077
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4867 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2615
Phone
(951) 321-6365
Fax
(951) 784-3264
NPI assigned
Nov 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 510657874 UT
Podiatrist 213E00000X E4867 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2615

Mailing address

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 321-6365

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ31887ZOtherCASITE PTAN #

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110808000617 CA Practitioner - Podiatry 2567523889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue46
Removal or shaving of skin growth29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4867CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Podiatrist CurrentSince Dec 12, 2016 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
RMC Surgery Center, LLC Past Accepting new patients

Locations

7160 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3714

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1467607077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-321-6365",
            "fax_number": "951-784-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062615",
            "telephone_number": "951-321-6365",
            "fax_number": "951-784-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAEGLE",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "510657874",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN #",
            "identifier": "ZZZ31887Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.