Individual provider Active NPI

Derrick Beckman, PA-C

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1760182935
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
127468 Issued in IA
Practice address
4326 Hickman Rd Ste 100
Des Moines, IA 50310-3302
Phone
(515) 271-6333
Fax
(515) 271-6379
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 127468 IA Primary

Addresses

Primary practice location

4326 Hickman Rd Ste 100
Des Moines, IA 50310-3302

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 271-6333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240910002994 IA Practitioner - Physician Assistant 2466992060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

6601 SW 9TH St
Des Moines, IA 50315-6138
Phone (515) 643-8350

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127468IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Mercy Clinics Inc Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Mercy Clinics, Inc PastSince Sep 1, 2024 Accepting new patients

Locations

800 E 1st St
Ste 1700
Ankeny, IA 50021
Phone (515) 643-8100

2605 SW White Birch Dr
Ankeny, IA 50023
Phone (515) 643-7100

1601 NW 114th St
Ste 247
Des Moines, IA 50325
Phone (515) 222-7000

6601 SW 9th St
Des Moines, IA 50315
Phone (515) 643-9400

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

4326 Hickman Rd
Ste 100
Des Moines, IA 50310
Phone (515) 271-6333

307 E Scenic Valley Ave
Indianola, IA 50125
Phone (515) 961-8448

5900 E University Ave
Ste 100
Pleasant Hill, IA 50327
Phone (515) 643-2400

Interoperability endpoints

  • Direct secure messaging: dbeckman3939249@direct.trinity-health.org

Organizations & group practices 5

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 4

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": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1760182935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-271-6333",
            "fax_number": "515-271-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 HICKMAN RD STE 100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103302",
            "telephone_number": "515-271-6333",
            "fax_number": "515-271-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "DERRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "127468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.