Derek G Kenneaster, MD is a medicare enrolled "Dermatology" physician in Herrin, Illinois. His current practice location is
220 N Park Ave, Suite 2, Herrin, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 942-3344.
Derek G Kenneaster is licensed to practice in Florida (license number ME94334) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457372724.
Physician's Profile
Full Name | Derek G Kenneaster |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 220 N Park Ave, Herrin, Illinois |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Derek G Kenneaster attended and graduated from in
NPI Data:
- NPI Number: 1457372724
- Provider Enumeration Date: 07/22/2006
- Last Update Date: 03/23/2011
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Derek G Kenneaster such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457372724 | NPI | - | NPPES |
036093018 | Medicaid | IL | |
10007459 | Other | | BCBS |
65958 | Other | | MEDICARE PTAN |
31057 | Other | FL | BCBS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | ME94334 (Florida) | Primary |
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 G Kenneaster 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 G Kenneaster, MD 220 N Park Ave, Suite 2, Herrin, IL 62948-3150 Ph: (618) 942-3344 | Derek G Kenneaster, MD 220 N Park Ave, Suite 2, Herrin, IL 62948-3150 Ph: (618) 942-3344 |
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