Dr Theodore Scott Derse, MD is a medicare enrolled "Family Medicine" physician in Zebulon, North Carolina. He went to Uniformed Services Uhs Fe Hebert School Of Med and graduated in 1992 and has 32 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Wake Specialty Physicians Llc and his current practice location is
1260 N Arendell Ave, Zebulon, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(919) 235-1965.
Dr Theodore Scott Derse is licensed to practice in North Carolina (license number 2022-01023) 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 1336254515.
Physician's Profile
| Full Name | Dr Theodore Scott Derse |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 32 Years |
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| Location | 1260 N Arendell Ave, Zebulon, North Carolina |
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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 Theodore Scott Derse attended and graduated from Uniformed Services Uhs Fe Hebert School Of Med in 1992
NPI Data:
- NPI Number: 1336254515
- Provider Enumeration Date: 08/20/2006
- Last Update Date: 03/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 9638197502
- Enrollment ID: I20220711000512
Medical Identifiers
Medical identifiers for Dr Theodore Scott Derse such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336254515 | NPI | - | NPPES |
| 34175800 | Medicaid | WI | |
| 036139601 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 34915 (Wisconsin) | Secondary |
| 207Q00000X | Family Medicine | 036139601 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 2022-01023 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Wake Specialty Physicians Llc | 7416006085 | 153 |
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 Theodore Scott Derse allows following entities to bill medicare on his behalf.
| Entity Name | Wake Specialty Physicians Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942440375
PECOS PAC ID: 7416006085
Enrollment ID: O20090601000520 |
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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. Dr Theodore Scott Derse 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 |
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Dr Theodore Scott Derse, MD
Po Box 602195,
Charlotte, NC 28260-2195
Ph: (877) 498-4490 | Dr Theodore Scott Derse, MD
1260 N Arendell Ave,
Zebulon, NC 27597-8730
Ph: (919) 235-1965 |
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