Derek L McCrae, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

A69656 Issued in CA

Practice address

2880 Atlantic Ave
Suite 170
Long Beach, CA 90806-1714

Phone

(562) 492-9900

Fax

(562) 492-9902

NPI assigned

Apr 20, 2007

Last updated

Dec 13, 2013By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Cardin Healthcare, a Medical Group, Inc.

  • Case Manager/Care Coordinator
  • Long Beach, CA
  • NPI 1043640063
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1881812402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "SUITE 170",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-492-9900",
            "fax_number": "562-492-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "SUITE 170",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-492-9900",
            "fax_number": "562-492-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAE",
        "first_name": "DEREK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A69656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARDIN HEALTHCARE",
            "identifier": "1043640063",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A69656",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci Elaine McCorvey Bray, MASTERS (MFTC)
• Carmen McCorvey
• Pamela McCowen
• Justin L McCoy, MD
• Laura Sech McCracken, M.D.
• Kaylynn Ashley McCrae, RN
• Ebonee McCray, MS
• Erin N McCuan, LCSW
• Dena Marie McCulley, RKT
• Mary McCullough, L.AC.

• Pediatric Adolescent Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.