Derek B Hamblin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-11020 Issued in ID

Practice address

4815 Cleveland Blvd
Caldwell, ID 83605-6501

Phone

(208) 455-3545

NPI assigned

Jun 30, 2006

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 ID

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

Family Practice

Education

Oregon Health Sciences University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.87 of 100Reported as group

Quality

77.29

Promoting interoperability

97

Improvement activities

40

Cost

74.78

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.hamblin@phmg.eclinicaldirectplus.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.

• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920
  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203
  NPD
• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Kuna, ID
  • NPI 1780298430
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1790713204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056501",
            "telephone_number": "208-455-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "DEREK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-11020",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD23651",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00479099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melina Guzman
• Gyst Counseling & Wellness LLC
• Thao Thi Thu Ha, LMSW
• Sean Haggerty, PMHNP-BC
• Marla Gaye Hale
• Dylan Jacob Joseph Hammer, PHARMD
• Ashley Hammond
• Emily Hammond, RN
• Richard D Hammond, LSW
• Sheila D Hancock, LMSW

• Family Medicine Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.