Look up the most recent NPI and PECOS records

Derek Derkacs

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Derek Derkacs 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 yesterday at 9:43 AM.

Profile Details

Provider ID
1720157720
Provider Type
Individual
Full Name
Derkacs, Derek
Title
Mr.
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
11/6/2006
Last Updated
4/10/2019

Contact Information

Practice Location

100 E. Idaho St, Boise, ID 83712

(208) 381-2733

(208) 381-2482

Mailing Location

100 E. Idaho St, Boise, ID 83712

(208) 381-2733

(208) 381-2482

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA-740 Idaho

Derek Derkacs

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Newman, Nicholas Cary

Talford, David B

Sweeten, Harley Neil

Lynn, Michael Brian

Vitto, Anthony David

Blea, Kacey

Nielson, David E

Chism, Sarah

Johnson, Connor

Riggs, Rodney