Derrick Evan Hall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD193186 Issued in OR

Practice address

16770 SW Edy Rd Ste 102
Sherwood, OR 97140

Phone

(503) 216-9600

NPI assigned

Jun 7, 2016

Last updated

Mar 11, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Medical College of Wisconsin, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Hospice Hospice, Portland, OR, CCN 381500
• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dhall1135104@oc.providencedirect.org

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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba PMG Molalla

  • Family Medicine Physician
  • Molalla, OR
  • NPI 1255641064
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Internal Medicine Physician
  • Tigard, OR
  • NPI 1093815243
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Hospice

  • Community Based Hospice Care Agency
  • Portland, OR
  • NPI 1205924313
  Care Compare affiliation

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1497104715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16770 SW EDY RD STE 102",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "97140",
            "telephone_number": "503-216-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4403 Harrison Blvd",
            "address_2": "Suite A-700",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844033271",
            "country_code": "US",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4403 Harrison Blvd",
            "address_2": "Suite A-700",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844033271",
            "country_code": "US",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "DERRICK",
        "middle_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD193186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhall1135104@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "16770 SW Edy Rd Ste 102",
            "city": "Sherwood",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Guided Health, PC (Guided Health)
• Xin Guo
• Andrea Tasia Hackett, CCC-SLP
• Samuel Joseph Hadley, CSA
• Eric Hagemeister
• Justin Harle, P.T.
• Nellab Hashimi, DDS
• Margaret Rose Havlik, ND
• Jacqueline J Head, PSY.D. PC
• Healing Therapy Solutions LLC

• Family Medicine Physician in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.