Melissa Derr, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9111920 Issued in FL

Practice address

8767 Perimeter Park Blvd
Jacksonville, FL 32216-5479

Phone

(904) 402-8346

Fax

(904) 402-8347

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

No

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

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 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: melissaderr@cvsapa.allscriptsdirect.net

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.

• Cardiothoracic & Vascular Surgical Associates PA

  • Vascular & Interventional Radiology Physician
  • Jacksonville, FL
  • NPI 1851403125
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1487128609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 SUMMIT RIDGE RD",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034967",
            "telephone_number": "813-148-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8767 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165479",
            "telephone_number": "904-402-8346",
            "fax_number": "904-402-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERR",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9111920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Annis Derival, LPN
• Jeltsje Willemien Derksen, PT
• Dermatology Group of Florida PA
• Dermatology Specialists of North Florida, P.a.
• Alexandra Derr, DO
• Leanne Derrico, ARNP
• Clara Derry, DPT
• Jenifer Derstine, ARNP
• Lisa Marie Derubeis
• Marie Lynne Deruyter, M.D.

• Medical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.