Individual provider Active NPI

Jennifer L Derrick, MD

  • Hospice and Palliative Medicine (Surgery) Physician
  • Mankato, MN
National Provider Identifier
1700083680
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Surgery) PhysicianTaxonomy code 2086H0002X
License
50807 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001
Phone
(507) 625-4031
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Surgery) Physician 2086H0002X 102956-875 WI
Hospice and Palliative Medicine (Surgery) Physician 2086H0002X 50807 MN Primary
Emergency Medicine Physician 207P00000X 50807 MN
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X 50807 MN

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001

Mailing address

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Other practice location 1

1025 Marsh St
Mankato, MN 56001
Phone (507) 625-4031

Other practice location 2

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jderrick89998@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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

Enrollment IDStateProvider typePAC IDDetails
I20081022000303 MN Practitioner - Hospice/Palliative CarePractitioner - Emergency Medicine 7113085044 Reassigns benefits to 2 organizations
I20250827000776 WI Practitioner - Hospice/Palliative CarePractitioner - Emergency Medicine 7113085044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Emergency Medicine
Education
University of South Carolina School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50807MNMDHospice and Palliative Medicine (Surgery) Physician
102956-875WIMDHospice and Palliative Medicine (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Jan 11, 2022 Accepting new patients
Mayo Clinic CurrentSince Jan 11, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 1, 2010 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 1, 2010 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Jul 9, 2025 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1700083680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Marsh St",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "56001",
            "country_code": "US",
            "telephone_number": "507-625-4031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086H0002X",
            "taxonomy_group": "",
            "desc": "Surgery, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "102956-875",
            "primary": false
        },
        {
            "code": "2086H0002X",
            "taxonomy_group": "",
            "desc": "Surgery, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "50807",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "50807",
            "primary": false
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "50807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jderrick89998@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.