Dr Katherine Dornan Derby, MD, MS - Medicare Obstetrics & Gynecology in Chicago, IL

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Dr Katherine Dornan Derby, MD, MS is a medicare enrolled "Obstetrics & Gynecology" physician in Chicago, Illinois. Her current practice location is 5140 N California Ave Fl 6, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (773) 878-7787.

Dr Katherine Dornan Derby is licensed to practice in Illinois (license number 036157085) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538654256.

Contact Information

Dr Katherine Dornan Derby, MD, MS
5140 N California Ave Fl 6,
Chicago, IL 60625-3645
(773) 878-7787
Not Available

Map and Direction




Physician's Profile

Full NameDr Katherine Dornan Derby
GenderFemale
SpecialityObstetrics & Gynecology
Location5140 N California Ave Fl 6, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1538654256
  • Provider Enumeration Date: 06/25/2018
  • Last Update Date: 07/15/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3072860055
  • Enrollment ID: I20220804003160

Medical Identifiers

Medical identifiers for Dr Katherine Dornan Derby such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538654256NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 125073316 (Illinois)Secondary
207V00000XObstetrics & Gynecology 036157085 (Illinois)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. Dr Katherine Dornan Derby allows following entities to bill medicare on her behalf.
Entity NameSwedish Covenant Management Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760432348
PECOS PAC ID: 4486556016
Enrollment ID: O20040123000850
Entity NameNorthshore University Healthsystem Faculty Practice Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497701882
PECOS PAC ID: 2163334699
Enrollment ID: O20040524000118

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 Katherine Dornan Derby 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 AddressPractice Location Address
Dr Katherine Dornan Derby, MD, MS
5140 N California Ave Fl 6,
Chicago, IL 60625-3645

Ph: (773) 878-7787		Dr Katherine Dornan Derby, MD, MS
5140 N California Ave Fl 6,
Chicago, IL 60625-3645

Ph: (773) 878-7787

Reviews and Comments


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Rebekah Osgood, M.D.
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Dr. Sarah Hoque, M.D.
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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