Active NPI
Derek J Meyer, MD
- Family Medicine Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD60859652
- Practice address
- 700 NE 87TH Ave Ste 110
Vancouver, WA 98664-4896 - Phone
- (360) 882-2778
- Fax
- (360) 604-1761
- NPI assigned
- Apr 1, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD176909 | OR | |
| Family Medicine Physician | 207Q00000X | MD60859652 | WA | Primary |
Addresses
Primary practice location
700 NE 87TH Ave Ste 110
Vancouver, WA 98664-4896
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778
Other practice location 1
1350 NE 122nd Ave
Suite 200
Portland, OR 97230-2011
Phone (503) 408-7008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2062945 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD176909 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Family Medicine | Current | Accepting new patients |
Locations
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
501 SE 172nd Ave
Vancouver, WA 98684
700 NE 87th Ave
Ste 110
Vancouver, WA 98664
Phone (360) 397-2534
Interoperability endpoints
- dmeyer13285@tvc-direct.org
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.
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
Family Medicine
-
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538956800000",
"number": "1972879153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE STE 110",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1761"
}
],
"practiceLocations": [
{
"address_1": "1350 NE 122nd Ave",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972302011",
"country_code": "US",
"telephone_number": "503-408-7008",
"fax_number": "503-408-7045",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEYER",
"first_name": "DEREK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-01",
"last_updated": "2018-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD176909",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD60859652",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2062945",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.