Derek James Detemple, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

3763 Issued in AZ

Practice address

1741 E Morten Ave Ste C1
Phoenix, AZ 85020-4645

Phone

(602) 870-0194

NPI assigned

Nov 22, 2005

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 4

Medicare fee-for-service enrollment

Enrolled in AZ, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddetemple7669@ahs.direct-ci.com
• Direct secure messaging: ddetemple143759@direct.phs.org

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.

• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Nes Arizona Inc

  • Emergency Medicine Physician
  • Fort Mohave, AZ
  • NPI 1285163121

  NM

  Medicare reassignment NPD
• Alteon Health New Mexico LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1457636706
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Quantum Healthcare Medical Associates of Arizona, PC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1821391269

  AZ

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470

  Emergency Medicine

  NPD
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Team Physicians of Arizona PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1710915764
  NPD (past)
• Albuquerque ER LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1558838607
  NPD (past)
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1992788095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 E MORTEN AVE STE C1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204645",
            "telephone_number": "602-870-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 E MORTEN AVE STE C1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204645",
            "telephone_number": "602-870-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETEMPLE",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "695942",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET - GROUP #",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE - GROUP #",
            "identifier": "3981220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Hands Medical Staffing
• Destiny Outpatient Services
• Destiny Sober Living
• Destiny Sober Living
• Richard Destrade Hernandez Sr., PA
• Morgan Detering, NMD
• Dru Dethlefs, D.O.
• Daniella Darlene Detjens
• Corey L Detlefs, MD
• Erin C Detorie, CNP

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.