Look up the most recent NPI and PECOS records

Elliot Derricotte

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

759 Chestnut St, Springfield, MA 01199-1001

PECOS Enrollment

Based on the most recent information from CMS, provider Elliot Derricotte is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1467083402
Provider Type
Individual
Full Name
Derricotte, Elliot
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
1/29/2020
Last Updated
6/18/2020

Contact Information

Practice Location

759 Chestnut St, Springfield, MA 01199-1001

(413) 794-6297

(413) 794-1767

Mailing Location

280 Chestnut St Fl 2, Springfield, MA 01199-1001

(413) 794-5700

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA7519 Massachusetts

Elliot Derricotte

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Gaudet, Claudia J

Cole, Jennifer F

O'Brien, Dennis S

Pedigo, Kimberly A

Arnopolin, Suzanne L

Sprague, Roxanne R

Gioranino, Gina M

Paddleford, Bonnie H

Glick, Melissa

Fisher, Rebecca A