Micah Jon Derby, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5550 Issued in OK

Practice address

6600 S Yale Ave Ste 650
Tulsa, OK 74136-3342

Phone

(918) 502-7800

Fax

(918) 502-7815

NPI assigned

May 8, 2013

Last updated

Oct 15, 2024By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

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

Internal Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
• Oklahoma State University Medical Center Hospital, Tulsa, OK, CCN 370078

Merit-based Incentive Payment System (MIPS)

Final score

93.91 of 100Reported as group

Quality

77.78

Promoting interoperability

99

Improvement activities

40

Cost

73.95

Merit-based Incentive Payment System (MIPS)

Final score

91.06 of 100Reported as apm

Quality

75.25

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mderby213895@direct.saintfrancis.com

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.

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment Care Compare group NPD
• Oklahoma State University

  dba OSU Speech-Language-Hearing Clinic

  • Speech-Language Pathologist
  • Stillwater, OK
  • NPI 1700994878
  Medicare reassignment NPD
• Oklahoma State University

  dba OSU Physicians Clinical Laboratory

  • Clinical Medical Laboratory
  • Tulsa, OK
  • NPI 1326495433
  NPD
• Oklahoma State University Medical Trust

  dba Oklahoma State University Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1578704938
  NPD (past)

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

• Oklahoma State University Medical Trust

  dba Oklahoma State University Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1578704938
  Care Compare affiliation
• Saint Francis Hospital South LLC

  dba Saint Francis Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1548605199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 650",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363342",
            "telephone_number": "918-502-7800",
            "fax_number": "918-502-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "MICAH",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200541190B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200541190A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "442012YMSD",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Wyatt Denton
• Nevada Lynn Denton
• Sally Denton
• Tara Denton, DDS
• Denver Professional Reading LLC
• Gayle Derington, M.D.
• Dermatology and Laser Center of Oklahoma
• Dermatology Associates of Oklahoma LLC
• Dermatology Associates of Tulsa LLC
• Kim Deroin

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.