Derrick Kyle Pelton, NP in Santa Rosa, CA - Medicare Nurse Practitioner

Derrick Kyle Pelton, NP is a medicare enrolled "Nurse Practitioner - Family" in Santa Rosa, California. He graduated from nursing school in 2013 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Sutter Bay Medical Foundation and his current practice location is 3883 Airway Dr Ste 120, Santa Rosa, California. You can reach out to his office (for appointments etc.) via phone at (707) 521-4495.

Derrick Kyle Pelton is licensed to practice in California (license number 95012148) 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 1609208354.

Contact Information

	Derrick Kyle Pelton, NP
	3883 Airway Dr Ste 120, Santa Rosa, CA 95403-1678
	(707) 521-4495
	(707) 573-5421

Map and Direction

Provider's Profile

Full Name	Derrick Kyle Pelton
Gender	Male
Speciality	Nurse Practitioner
Experience	11 Years
Location	3883 Airway Dr Ste 120, Santa Rosa, California
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:

Derrick Kyle Pelton graduated from nursing school in 2013

NPI Data:

NPI Number: 1609208354
Provider Enumeration Date: 08/05/2013
Last Update Date: 02/09/2022

Medicare PECOS Information:

PECOS PAC ID: 6800030834
Enrollment ID: I20191118000215

Medical Identifiers

Medical identifiers for Derrick Kyle Pelton such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609208354	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95012148 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sutter Santa Rosa Regional Hospital	Santa rosa, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sutter Bay Medical Foundation	4284538778	2995

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. Derrick Kyle Pelton allows following entities to bill medicare on his behalf.

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909

Entity Name	San Francisco Emergency Medical
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134110661 PECOS PAC ID: 5698662518 Enrollment ID: O20040303001130

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. Derrick Kyle Pelton 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
Derrick Kyle Pelton, NP 325 Distel Cir, Los Altos, CA 94022-1408 Ph: (707) 521-4495	Derrick Kyle Pelton, NP 3883 Airway Dr Ste 120, Santa Rosa, CA 95403-1678 Ph: (707) 521-4495

Reviews and Comments

Nurse Practitioner Nurses in Santa Rosa, CA

Peggy Walsh Goebel, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 50 Montgomery Dr, Santa Rosa, CA 95404 Phone: 707-585-7780 Fax: 707-585-7784
Julie Barlow, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1165 Montgomery Dr, Santa Rosa, CA 95405 Phone: 707-525-5207
Suzanne Watts Dedmore, RN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1110 N Dutton Ave, Santa Rosa, CA 95401 Phone: 707-303-3600
Amada Ligia Gomez, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1989 Citrine Way, Santa Rosa, CA 95404 Phone: 786-385-4492
Genesis Callejas-mir, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1501 Mendocino Ave, Santa Rosa, CA 95401 Phone: 707-527-4445
Felipa Jones, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3317 Chanate Rd, Suite 2c, Santa Rosa, CA 95404 Phone: 707-570-1130 Fax: 707-571-2478
Cynthia R. Ingels, MSN,N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Doyle Park Dr, Suite 103, Santa Rosa, CA 95405 Phone: 707-579-1102

Derrick Kyle Pelton, NP - Medicare Nurse Practitioner in Santa Rosa, CA