Derrick Tang, PA-C

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

PA.0006964 Issued in CO

Practice address

4856 Innovation Dr
Fort Collins, CO 80525-5539

Phone

(970) 494-4200

Fax

(844) 270-1824

NPI assigned

Aug 14, 2020

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Male

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 AZ, CO2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Summitstone Health Partners

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Collins, CO
  • NPI 1821552738
  Medicare reassignment
• Longview Behavioral Health

  • Clinical Medical Laboratory
  • Fort Collins, CO
  • NPI 1194572545
  NPD
• Summitstone Health Partners

  dba Acute Care Facility at Longview

  • Adult Mental Health Clinic/Center
  • Fort Collins, CO
  • NPI 1154135861
  NPD
• Longview Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Collins, CO
  • NPI 1164269809
  NPD (past)
• Longview Behavioral Health

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1700567096
  NPD (past)
• Longview Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Collins, CO
  • NPI 1992486278
  NPD (past)
• Summitstone Health Partners

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Collins, CO
  • NPI 1023799301
  NPD (past)
• Summitstone Health Partners

  dba Acute Care Facility Pharmacy at Longview

  • Community/Retail Pharmacy
  • Fort Collins, CO
  • NPI 1730935222
  NPD (past)

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1487265278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "DERRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "PA.0006964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elia Talavera
• Ashley H Talbot, BS
• Talem Home Care of Fort Collins, LLC
• Tammi Vacha Haase PHD LLC
• Tandem Employment Services Inc
• Tanglewood Collective PLLC
• Jennifer L Tanguay, LCSW
• Taola Enterprises LLC (Lighthouse Chiropractic)
• Vivian Margaret Tapp
• Marla J Tappy, P.T., ATC

• Psychiatry Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.