Individual provider Active NPI

Derek Tuley, LCSW

  • Clinical Social Worker
  • Abilene, TX
National Provider Identifier
1629447255
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
41227 Issued in TX
Practice address
5849 Buffalo Gap Rd Ste E
Abilene, TX 79606-1263
Phone
(817) 925-7047
NPI assigned
Sep 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 41227 TX Primary

Addresses

Primary practice location

5849 Buffalo Gap Rd Ste E
Abilene, TX 79606-1263

Mailing address

5849 Buffalo Gap Rd Ste E
Abilene, TX 79606-1263
Phone (817) 925-7047

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CombestWellness@direct.myteamcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151228001234 TX Practitioner - Clinical Social Worker 4789985383 Reassigns benefits to 1 organization
Practice locations: Abilene, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

318 Cedar St
Abilene, TX 79601-5722
Phone (325) 672-7055

5849 Buffalo Gap Rd
Suite E
Abilene, TX 79606-1263
Phone (817) 925-7047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center - Son - Lubbock CurrentSince Nov 17, 2017 Accepting new patients
Texas Tech University Health Sciences Center - Son - Lubbock Clinical CurrentSince Nov 17, 2017 Accepting new patients

Locations

1749 Pine St
Abilene, TX 79601
Phone (325) 672-4372

301 40th St
Lubbock, TX 79404
Phone (806) 743-9355

Organizations & group practices 2

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1629447255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP RD STE E",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061263",
            "telephone_number": "817-925-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP RD STE E",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061263",
            "telephone_number": "817-925-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULEY",
        "first_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "41227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CombestWellness@direct.myteamcare.com",
            "affiliation": "N",
            "endpointDescription": "SON-Combast Non-Clinical",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 40th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794042746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.