Derek Potter, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8760465-1206 Issued in UT

Practice address

379 N 500 W
Suite 1a
Vernal, UT 84078-1956

Phone

(435) 789-1165

Fax

(435) 789-1169

NPI assigned

Aug 15, 2013

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 UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uintah Basin Medical Center Hospital, Roosevelt, UT, CCN 460019

Merit-based Incentive Payment System (MIPS)

Final score

89.32 of 100Reported as apm

Quality

71.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Northeastern Utah Medical Group

  • Family Medicine Physician
  • Roosevelt, UT
  • NPI 1982664199
  Medicare reassignment Care Compare group NPD
• Basin Medical Clinic LLC

  • Family Medicine Physician
  • Vernal, UT
  • NPI 1396838918
  NPD (past)

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

• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217
  Care Compare affiliation
• Uintah Basin Medical Center

  dba Uintah Basin Medical Center Vernal

  • General Acute Care Hospital
  • Vernal, UT
  • NPI 1881447571
  Care Compare affiliation
• Uintah Basin Medical Center

  dba UBMC Physical Therapy

  • Physical Therapy Clinic/Center
  • Ballard, UT
  • NPI 1912750662

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1679906481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 N 500 W",
            "address_2": "SUITE 1A",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781956",
            "telephone_number": "435-789-1165",
            "fax_number": "435-789-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 N 500 W",
            "address_2": "SUITE 1A",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781956",
            "telephone_number": "435-789-1165",
            "fax_number": "435-789-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "DEREK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8760465-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tylee Deann Pierce
• Bruce A Piispanen
• Sara Ann Pittman, LMT
• Olivia Ray Pope
• Joe Porter, P.A.
• Adrianna Troy Potts
• Praxair Healthcare Services, Inc.
• Precision Learning & Behavioral Consulting
• Torilynn Price, FNP
• R K Jolley DDS PC

• Physician Assistant in Vernal, UT
• Providers in Vernal, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.