NPIMap

Individual provider Active NPI

Derrick D Kooker, P.A.

  • Surgical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1851373526
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0003166 Issued in CO
Practice address
2312 N Nevada Ave Ste 235
Colorado Springs, CO 80907-5312
Phone
(719) 776-7600
Fax
(719) 473-3553
NPI assigned
Nov 17, 2005
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA961 KY
Surgical Physician Assistant 363AS0400X PA.0003166 CO Primary

Addresses

Primary practice location

2312 N Nevada Ave Ste 235
Colorado Springs, CO 80907-5312

Mailing address

2222 N Nevada Ave
Suite
Colorado Springs, CO 80907-6819
Phone (719) 776-7600

Other practice location 1

2222 N Nevada Ave
Suite
Colorado Springs, CO 80907-6819
Phone (719) 776-7600

Other identifiers 2

IdentifierTypeStateIssuer
P00604454OtherKYRAILROAD MEDICARE
7100001170MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20111017000277 CO Practitioner - Physician Assistant 0446254023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

2222 N Nevada Ave
Colorado Springs, CO 80907-6819

2312 N Nevada Ave
Suite 235
Colorado Springs, CO 80907-5312
Phone (719) 776-7600

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01240IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Hospital Association CurrentSince Oct 1, 2018 Accepting new patients
Valley View Hospital Association CurrentSince Oct 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 9, 2011 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 9, 2011 Accepting new patients
Iowa Heart Center PC Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Owensboro Health Medical Group Inc Past Accepting new patients
Cardio Surgeons of Colorado Springs Past Accepting new patients
Owensboro Health Medical Group, Inc Physician Assistant Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

2222 N Nevada Ave
Ste 4002
Colorado Springs, CO 80907
Phone (719) 473-3550

2312 N Nevada Ave
Ste 235
Colorado Springs, CO 80907
Phone (719) 571-8840

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 12

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 2

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1851373526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "address_2": "SUITE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-776-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE STE 235",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075312",
            "telephone_number": "719-776-7600",
            "fax_number": "719-473-3553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave",
            "address_2": "Suite",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "719-776-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOKER",
        "first_name": "DERRICK",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA961",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0003166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00604454",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100001170",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.