Dr Derek Proctor Richardson, MD is a medicare enrolled "Dermatology" physician in Glens Falls, New York. His current practice location is
Four Irongate Center, Glens Falls, New York. You can reach out to his office (for appointments etc.) via phone at
(518) 798-1778.
Dr Derek Proctor Richardson is licensed to practice in New York (license number 114475) 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 1568552719.
Physician's Profile
| Full Name | Dr Derek Proctor Richardson |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | Four Irongate Center, Glens Falls, New York |
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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. |
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Medical Education and Training:
- Dr Derek Proctor Richardson attended and graduated from in
NPI Data:
- NPI Number: 1568552719
- Provider Enumeration Date: 10/16/2006
- Last Update Date: 10/28/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Derek Proctor Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568552719 | NPI | - | NPPES |
| 000407083001 | Other | NY | BLUE SHIELD |
| 040426007626 | Other | NY | FIDELIS |
| 07121 | Other | NY | MVP HEALTH PLAN |
| 10001709 | Other | NY | CDPHP |
| 141622071 | Other | | TAX ID # |
| 48F2111 | Other | NY | BLUE CROSS |
| 00352149 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 114475 (New York) | 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. Dr Derek Proctor Richardson 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 |
|---|
Dr Derek Proctor Richardson, MD
Four Irongate Center,
Glens Falls, NY 12801
Ph: (518) 798-1778 | Dr Derek Proctor Richardson, MD
Four Irongate Center,
Glens Falls, NY 12801
Ph: (518) 798-1778 |
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