Derek Paul Mora, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

BP10066858 Issued in TX

Practice address

1475 Medical Pkwy
Carson City, NV 89703-4635

Phone

(775) 885-2229

Fax

(775) 882-5045

NPI assigned

Apr 16, 2019

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 NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.mora@cmg1.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/ABJDAA

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.

• Carson Medical Group Professional Corporation

  • Family Medicine Physician
  • Carson City, NV
  • NPI 1780694620

  Pediatrics

  Medicare reassignment NPD
• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  NPD (past)

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1649833609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 OLD HOT SPRINGS RD",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897060674",
            "telephone_number": "775-882-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034635",
            "telephone_number": "775-885-2229",
            "fax_number": "775-882-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "DEREK",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10066858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica H. Wichner, DO LTD
• David Moniz-Lewis, CADCI
• Ashlee Montgomery, NP
• Ryan M Monti, M.D.
• Brittany Moose
• Justus Mora
• Priscila Morales
• Diana Lynn Morgan
• Tavin B Morgan, DPM
• Rebecca Ruthanne Morian, RN

• Pediatrics Physician in Carson City, NV
• Providers in Carson City, NV by specialty
• Pediatrics Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.