NPIMap

Individual provider Active NPI

Derek James Skop, DO

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1932848975
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS21074 Issued in FL
Practice address
12301 Lake Underhill Rd Ste 215
Orlando, FL 32828-4511
Phone
(321) 235-0692
Fax
(321) 235-0694
NPI assigned
May 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS21074 FL Primary

Addresses

Primary practice location

12301 Lake Underhill Rd Ste 215
Orlando, FL 32828-4511

Mailing address

12301 Lake Underhill Rd Ste 215
Orlando, FL 32828-4511
Phone (321) 235-0692

Other identifiers 1

IdentifierTypeStateIssuer
124429000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241017004212 FL Practitioner - General PracticePractitioner - Family Practice 4284016874 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Nova Southeastern College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care of Central Florida IncGroup PAC ID 8628094018, 39 clinicians
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

12301 Lake Underhill Rd
Suite 215
Orlando, FL 32828-4511
Phone (321) 235-0692

514 SE Port St Lucie Blvd
Port Saint Lucie, FL 34984-5108
Phone (772) 871-5900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care of Central Florida Inc Family Medicine CurrentSince Sep 23, 2024 Accepting new patients
Home Physicians Group LLC Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Mar 2, 2026 Accepting new patients

Locations

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

3564 E Avalon Park Blvd
Orlando, FL 32828
Phone (407) 405-4741

12301 Lake Underhill Rd
Ste 215
Orlando, FL 32828
Phone 3212350692102

514 SE Port St Lucie Blvd
Port St Lucie, FL 34984
Phone (772) 871-5900

Interoperability endpoints

  • Direct secure messaging: derek.skop@4081.securemail.prognocis.com

Organizations & group practices 3

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 9

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": "1653696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1932848975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 LAKE UNDERHILL RD STE 215",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284511",
            "telephone_number": "321-235-0692",
            "fax_number": "321-235-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 LAKE UNDERHILL RD STE 215",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284511",
            "telephone_number": "321-235-0692",
            "fax_number": "321-235-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOP",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-28",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS21074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124429000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.