Derek J Peacock, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD00036578 Issued in WA

Practice address

1305 Fowler St Ste 1D
Richland, WA 99352-4719

Phone

(509) 940-2284

NPI assigned

Jun 30, 2005

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

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

RheumatologyAlso: Internal Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PNW Arthritis and Rheumatology PLLCGroup PAC ID 0840781944, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Good Shepherd Medical Center Hospital, Hermiston, OR, CCN 381325
• Lourdes Medical Center Hospital, Pasco, WA, CCN 501337
• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpeacock1108630@wm.providencedirect.org
• FHIR API: https://fhir4.healow.com/fhir/r4/FJCJDD

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.

• PNW Arthritis and Rheumatology PLLC

  • Rheumatology Physician
  • Richland, WA
  • NPI 1861285074
  Medicare reassignment Care Compare group NPD Authorized official

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Lourdes Hospital LLC

  • Critical Access Hospital
  • Pasco, WA
  • NPI 1831284280
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation
• Yakima Valley Memorial Hospital Association

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480
  Care Compare affiliation
• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1720085038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 FOWLER ST STE 1D",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524719",
            "telephone_number": "509-940-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 FOWLER ST STE 1D",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524719",
            "telephone_number": "509-940-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "DEREK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD00036578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0152619",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8477630",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "660003458",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpeacock1108630@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6710 W Okanogan Pl",
            "address_2": "Kadlec Clinic Rheumatology",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "99336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael J Pattillo, MD
• Nicholas William Paulakis, LMHCA
• Gregory Michael Paup
• Jennifer Pawlowski, B.S.
• Benjamin David Pe, M.D.
• Peak Performance Physical Therapy, PLLC
• Anthony Pech, DO
• Jeremy Walter Peck, M.D., PH.D.
• Julia Peck, MS, CCC/SLP, IBCLC
• Steven Henry Peck, MACP

• Rheumatology Physician in Richland, WA
• Providers in Richland, WA by specialty
• Rheumatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
• 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.