Derek Evan Burkhart, APRN-FNP is a medicare enrolled "Nurse Practitioner" physician in Hopkinsville, Kentucky. His current practice location is
320 W 18th St, Hopkinsville, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 887-0100.
Derek Evan Burkhart is licensed to practice in Kentucky (license number 3018279) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922728849.
Physician's Profile
| Full Name | Derek Evan Burkhart |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Location | 320 W 18th St, Hopkinsville, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1922728849
- Provider Enumeration Date: 08/31/2022
- Last Update Date: 09/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 7719363324
- Enrollment ID: I20221005002891
Medical Identifiers
Medical identifiers for Derek Evan Burkhart such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922728849 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208M00000X | Hospitalist | 3018279 (Kentucky) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 3018279 (Kentucky) | Secondary |
| 363L00000X | Nurse Practitioner | 3018279 (Kentucky) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Derek Evan Burkhart allows following entities to bill medicare on his behalf.
| Entity Name | Jennie Stuart Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235139312
PECOS PAC ID: 4183607252
Enrollment ID: O20040609001506 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derek Evan Burkhart is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Derek Evan Burkhart, APRN-FNP
25 Thomas Trce,
Cadiz, KY 42211-8404
Ph: (270) 350-7150 | Derek Evan Burkhart, APRN-FNP
320 W 18th St,
Hopkinsville, KY 42240-1965
Ph: (270) 887-0100 |
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