Kirsten Bailey Dericks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3211 Grant Line Rd Ste 15
New Albany, IN 47150-2175

Phone

(812) 221-1186

Fax

(949) 882-0452

NPI assigned

Jul 13, 2023

Last updated

Apr 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kirsten Bailey Gagel Former name

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Clark Medical Group LLCGroup PAC ID 3971879354, 21 clinicians

Momentum Behavioral Health Group LLCGroup PAC ID 4284118928, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4

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.

• Momentum Behavioral Health Group LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Albany, IN
  • NPI 1538010236

  Medical

  Medicare reassignment Care Compare group NPD Authorized official
• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711

  KY

  Medicare reassignment Care Compare group
• Lifeline Medical Center

  • Family Medicine Physician
  • Anderson, IN
  • NPI 1265160451
  Medicare reassignment NPD

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1689353930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 GRANT LINE RD STE 15",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502175",
            "telephone_number": "812-221-1186",
            "fax_number": "949-882-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 GRANT LINE RD STE 15",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502175",
            "telephone_number": "812-221-1186",
            "fax_number": "949-882-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERICKS",
        "first_name": "KIRSTEN",
        "middle_name": "BAILEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "GAGEL",
            "middle_name": "BAILEY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in New Albany, IN
• Providers in New Albany, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.