Individual provider Active NPI

Derek Lamont Tryial

  • Non-emergency Medical Transport (VAN)
  • Elk Grove, CA
National Provider Identifier
1922740158
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
35960R1 Issued in CA
Practice address
9245 Laguna Springs Dr Ste 213
Elk Grove, CA 95758-7991
Phone
(916) 529-2359
NPI assigned
Apr 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 35960R1 CA Primary

Addresses

Primary practice location

9245 Laguna Springs Dr Ste 213
Elk Grove, CA 95758-7991

Mailing address

9245 Laguna Springs Dr Ste 213
Elk Grove, CA 95758-7991
Phone (916) 529-2359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35960R1CAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
All Around Medical Transportation Non-Emergency Medical Transport (Van) Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1922740158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 LAGUNA SPRINGS DR STE 213",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587991",
            "telephone_number": "916-529-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 LAGUNA SPRINGS DR STE 213",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587991",
            "telephone_number": "916-529-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYIAL",
        "first_name": "DEREK",
        "middle_name": "LAMONT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "35960R1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.