Active NPI
Derek O Plotz, CRNA
- Certified Registered Nurse Anesthetist
- Madison, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 202208560CRNA-PP
- Practice address
- 700 S Park St
Madison, WI 53715-1830 - Phone
- (608) 251-6100
- Fax
- (608) 258-5222
- NPI assigned
- Apr 9, 2019
- Last updated
- May 11, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 202208560CRNA-PP | OR | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 193884 | WI |
Addresses
Primary practice location
700 S Park St
Madison, WI 53715-1830
Mailing address
500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000
Other practice location 1
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659834554 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dplotz387719@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2480 Liberty St NE
Suite 180
Salem, OR 97301-8388
Phone (503) 371-1010
9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-1234
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202208560CRNA-PP | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Washington - TCS | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Oregon Pain Management LLC | Current | Accepting new patients |
Locations
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
2480 Liberty St NE
Ste 180
Salem, OR 97301
Phone (503) 371-1010
Interoperability endpoints
- dplotz387719@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Portland, OR
- NPI 1649816380
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Salem, OR
- NPI 1679936579
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1659834554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 NE MULTNOMAH ST STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322031",
"telephone_number": "800-813-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100",
"fax_number": "608-258-5222"
}
],
"practiceLocations": [
{
"address_1": "10180 SE Sunnyside Rd",
"address_purpose": "LOCATION",
"city": "Clackamas",
"state": "OR",
"postal_code": "970158970",
"country_code": "US",
"telephone_number": "800-813-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PLOTZ",
"first_name": "DEREK",
"middle_name": "O",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-09",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "202208560CRNA-PP",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "193884",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1659834554",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dplotz387719@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "dplotz387719@direct-ehr-ssmhc.com",
"address_1": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.