Active NPI
Derek Randall Jenkins, M.D.
- Adult Reconstructive Orthopaedic Surgery Physician
- East Providence, RI
National Provider Identifier
1669613907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Reconstructive Orthopaedic Surgery Physician
- License
- 16277
- Practice address
- 1 Kettle Point Ave
East Providence, RI 02914-5375 - Phone
- (401) 453-9032
- Fax
- (401) 861-5812
- NPI assigned
- Mar 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 106300 | MN | |
| Orthopaedic Surgery Physician | 207X00000X | 55660 | MN | |
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 16277 | NH | Primary |
Addresses
Primary practice location
1 Kettle Point Ave
East Providence, RI 02914-5375
Mailing address
PO Box 1119
Providence, RI 02901-1119
Phone (401) 453-9032
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN | |
| ENROLLED | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Geisel School of Medicine at Dartmouth, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500
Hospital & facility affiliations
- Amedisys Home Health Care
- Amedisys Home Health Care
- Visiting Nurse Home and Hospice
- The Miriam Hospital
- Rhode Island Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 66.76
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 77
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 29 |
| Knee replacement | 55 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Interoperability endpoints
- derek.jenkins.1@13709.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Providence, RI
- NPI 1235181041
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- Home Health Agency
- Warwick, RI
- NPI 1770537854
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
-
- Nursing Care Agency
- Middletown, RI
- NPI 1972587699
Home health agency
-
- Home Health Agency
- Wakefield, MA
- NPI 1407800584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549929600000",
"number": "1669613907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1119",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029011119",
"telephone_number": "401-453-9032",
"fax_number": "401-861-5812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 KETTLE POINT AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "029145375",
"telephone_number": "401-453-9032",
"fax_number": "401-861-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "DEREK",
"middle_name": "RANDALL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-17",
"last_updated": "2019-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "106300",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "55660",
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "NH",
"license": "16277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.