Dawn Marie Derks, ACNS-BC, PMHNP-BC in Saint Paul, MN

Dawn Marie Derks, ACNS-BC, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Saint Paul, Minnesota. Her current practice location is 640 Jackson St, Saint Paul, Minnesota. You can reach out to her office (for appointments etc.) via phone at (651) 254-3665.

Dawn Marie Derks is licensed to practice in Wisconsin (license number 15001-33) 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 1396147377.

Contact Information

	Dawn Marie Derks, ACNS-BC, PMHNP-BC
	640 Jackson St, Saint Paul, MN 55101-2502
	(651) 254-3665
	Not Available

Map and Direction

Provider's Profile

Full Name	Dawn Marie Derks
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	640 Jackson St, Saint Paul, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396147377
Provider Enumeration Date: 09/21/2014
Last Update Date: 02/09/2024

Medicare PECOS Information:

PECOS PAC ID: 9830411339
Enrollment ID: I20240329001084

Medical Identifiers

Medical identifiers for Dawn Marie Derks such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396147377	NPI	-	NPPES
C02467	Other	MN	MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
364SA2200X	Clinical Nurse Specialist - Adult Health	2014005854 (Minnesota)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	15001-33 (Wisconsin)	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. Dawn Marie Derks allows following entities to bill medicare on her behalf.

Entity Name	Memorial Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437179231 PECOS PAC ID: 8022000447 Enrollment ID: O20040402000938

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. Dawn Marie Derks 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
Dawn Marie Derks, ACNS-BC, PMHNP-BC 1615 Maple Ln, Ashland, WI 54806-3626 Ph: (715) 685-5500	Dawn Marie Derks, ACNS-BC, PMHNP-BC 640 Jackson St, Saint Paul, MN 55101-2502 Ph: (651) 254-3665

Reviews and Comments

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Dawn Marie Derks, ACNS-BC, PMHNP-BC - Medicare Nurse Practitioner in Saint Paul, MN