Individual provider Active NPI

Derek Deng

  • Family Medicine Physician
  • Lebanon, OR
National Provider Identifier
1811657596
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A24650 Issued in CA
Practice address
200 Mullins Drive
Lebanon, OR 97355
Phone
(541) 259-0235
NPI assigned
Dec 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A24650 CA Primary

Addresses

Primary practice location

200 Mullins Drive
Lebanon, OR 97355

Mailing address

200 Mullins Drive
Lebanon, OR 97355

Other practice location 1

300 Hillmont Ave Bldg 340 Ste 101
Ventura, CA 93003
Phone (805) 652-6100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derek.deng@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20251119002401 CA Practitioner - Family Practice 7810488681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1885 FM
2673 Unit 146
Canyon Lake, TX 78133

800 S Victoria Ave
L4640
Ventura, CA 93009-0002

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24650CAMDClinical Social Worker
20A24650CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Oct 1, 2025 Accepting new patients
County of Ventura CurrentSince Oct 1, 2025 Accepting new patients

Locations

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

800 S Victoria Ave
#L4640
Ventura, CA 93009

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Interoperability endpoints

  • Direct secure messaging: derek.deng@ventura.cernerdirect.com

Organizations & group practices 2

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 1

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": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1811657596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DRIVE",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "97355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLINS DRIVE",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "97355",
            "telephone_number": "541-259-0235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hillmont Ave Bldg 340 Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "93003",
            "country_code": "US",
            "telephone_number": "805-652-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENG",
        "first_name": "DEREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-22",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A24650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derek.deng@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave Bldg 340 Ste 101",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "93003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.