Individual provider Active NPI

Derek Du, FNP

  • Family Nurse Practitioner
  • Orange, CA
National Provider Identifier
1689886863
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22816 Issued in CA
Practice address
3340 E Chapman Ave
Orange, CA 92869
Phone
(714) 912-1020
Fax
(714) 912-1021
NPI assigned
May 3, 2007
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22816 CA Primary

Addresses

Primary practice location

3340 E Chapman Ave
Orange, CA 92869

Mailing address

3340 E Chapman Ave
Orange, CA 92869
Phone (714) 912-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20130228000095 CA Practitioner - Nurse Practitioner 4789606369 Practice locations: Orange, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22816CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
VMC Wellness & Aesthetics Current Accepting new patients

Locations

3340 E Chapman Ave
Orange, CA 92869
Phone (714) 912-1020

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1689886863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92869",
            "telephone_number": "714-912-1020",
            "fax_number": "714-912-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92869",
            "telephone_number": "714-912-1020",
            "fax_number": "714-912-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.