Nicole Fame Derby, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1367 Washington Ave Ste 200
Albany, NY 12206-1048

Phone

(518) 489-2666

NPI assigned

Sep 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Springs Orthopaedic GroupGroup PAC ID 5395633747, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
• Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130

Merit-based Incentive Payment System (MIPS)

Final score

82.41 of 100Reported as group

Quality

56.02

Promoting interoperability

100

Improvement activities

40

Cost

85.34

Merit-based Incentive Payment System (MIPS)

Final score

83.06 of 100Reported as group

Quality

70.6

Promoting interoperability

99

Improvement activities

40

Cost

73.76

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nderby@csog.emadirect.md
• Direct secure messaging: nderby98314@albanymed.direct-ci.com

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.

• Colorado Springs Orthopaedic Group

  • Specialist
  • Colorado Springs, CO
  • NPI 1972578359
  Medicare reassignment Care Compare group NPD (past)
• Colorado Springs Orthopaedic Group

  • Specialist
  • Colorado Springs, CO
  • NPI 1356317135
  NPD
• Colorado Springs Orthopaedic Group

  • Durable Medical Equipment & Medical Supplies
  • Colorado Springs, CO
  • NPI 1417957275
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1801436415
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1932112125
  Care Compare affiliation
• Uchealth Grandview Hospital

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1619351160
  Care Compare affiliation

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1992428817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061048",
            "telephone_number": "518-489-2666",
            "fax_number": "518-489-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061048",
            "telephone_number": "518-489-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "NICOLE",
        "middle_name": "FAME",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Alessio Francesco Depoli, RPH
• Deowchand Depoo, M.D.
• Dion Depra
• Paul Jack Der Mesropian, D.O.
• Timothy S. Derenzo, M.D.
• Victoria Dergachova
• Sabrina Derhammer, DPT
• Claudelle Massena Deroche
• Steven Deroche, CRNA

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.

Verify at the official NPI Registry.