Deric H Nye, D.O.

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

009320 Issued in AZ

Practice address

5601 W Eugie Ave Ste 100
Glendale, AZ 85304-1256

Phone

(602) 865-4510

Fax

(602) 865-6100

NPI assigned

Feb 13, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dnye77244@valleychildrens-prd.direct-ci.com

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.

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Valley Children'S Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1396014403
  NPD

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1699014464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 W EUGIE AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041256",
            "telephone_number": "602-865-4510",
            "fax_number": "602-865-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W EUGIE AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041256",
            "telephone_number": "602-865-4510",
            "fax_number": "602-865-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Valley Childrens Pl",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368762",
            "country_code": "US",
            "telephone_number": "559-353-5941",
            "fax_number": "559-353-5945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Valley Childrens Pl # Fe10",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-5941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-6596",
            "fax_number": "419-251-6849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYE",
        "first_name": "DERIC",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CA",
            "license": "20A17398",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "AZ",
            "license": "009320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699014464",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uche Nwambuonwo, PT, DPT
• Nicole Elizabeth Zack Nwobodo, PA-C
• Kerubo Happiness Nyachieo, PMHNP
• George Oseko Nyakundi, MSN,PMHNP-BC
• Dan Nydegger, D.D.S.
• Elisabetta G Nyholm-Jensen, D.C.
• Michael Nyholm-Jensen, DC
• Shane James Nylin, MD
• Jessica Nystrom, FNP-C
• Callie O'Connor, MS

• Pediatric Orthopaedic Surgery Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.