NPIMap

Individual provider Active NPI

Derek S Buck, MD DC

  • Physical Medicine & Rehabilitation Physician
  • Bluefield, VA
National Provider Identifier
1790951432
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101251939 Issued in VA
Practice address
111E Sanders LN
Bluefield, VA 24605
Phone
(540) 552-7133
Fax
(540) 552-7143
NPI assigned
May 2, 2008
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 0101251939 VA Primary

Addresses

Primary practice location

111E Sanders LN
Bluefield, VA 24605

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other identifiers 1

IdentifierTypeStateIssuer
182259001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211002630 SD Practitioner - Physical Medicine and Rehabilitation 9638147382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101251939VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jan 14, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Jan 14, 2021 Accepting new patients
Monument Health Network, Inc. CurrentSince Apr 16, 2021 Accepting new patients
Monument Health Network, Inc. CurrentSince Apr 16, 2021 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Village Family Practice, L.L.P Past Accepting new patients
Virginia I-Spine Physicians, P.C Physical Medicine & Rehabilitation PastSince May 1, 2011 Accepting new patients
Anesthesia Solutions PLLC PastSince May 1, 2019 Accepting new patients
Queen City Regional Medical Clinic Past Accepting new patients
McGehee Desha County Hospital Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

2479 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 644-4460

Organizations & group practices 11

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1790951432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111E SANDERS LN",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "24605",
            "telephone_number": "540-552-7133",
            "fax_number": "540-552-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "DEREK",
        "middle_name": "S",
        "credential": "MD DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101251939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182259001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, VA

Sources for this page

Verify at the official NPI Registry.