Derek J McCammon, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DP00307 Issued in OR

Practice address

24076 SE Stark St Ste 110
Gresham, OR 97030-3374

Phone

(503) 661-5388

Fax

(503) 666-9393

NPI assigned

Nov 7, 2005

Last updated

Jan 26, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Orthopedic and Sports Medicine Clinic LLPGroup PAC ID 9335123868, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
• Adventist Health Portland Hospital, Portland, OR, CCN 380060

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.mccammon.1@10802.direct.athenahealth.com
• Direct secure messaging: dmccammon170916@direct.ohsu.edu
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Advantage Orthopedic and Sports Medicine Clinic LLP

  • Specialist
  • Gresham, OR
  • NPI 1598798365
  Medicare reassignment Care Compare group NPD
• Pearl Foot and Ankle LLC

  • Podiatrist
  • Portland, OR
  • NPI 1346008711
  NPD (past)

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

• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  Care Compare affiliation
• Portland Adventist Medical Center

  dba Adventist Health Portland

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1760463889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 110",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303374",
            "telephone_number": "503-661-5388",
            "fax_number": "503-666-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 110",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303374",
            "telephone_number": "503-661-5388",
            "fax_number": "503-666-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAMMON",
        "first_name": "DEREK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "DP00307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Mayer, AGPCNP
• Jayme Mayo, P.A-C
• Kristofer R McAllister, PA-C
• Prescott Briggs McArthur, OD
• Nonika Daleann McCallister, RN
• Tara G McCann, MSOT
• Colin McCartney
• Jennifer McClellan
• Molly Margaret McClellan
• Junette E McColl, LMT, C.A.

• Foot & Ankle Surgery Podiatrist in Gresham, OR
• Providers in Gresham, OR by specialty
• Foot & Ankle Surgery Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.