Derrick Cannon, PT, DPT in Fairbanks, AK - Medicare Physical Therapist Provider

Derrick Cannon, PT, DPT is a medicare enrolled "Physical Therapist" provider in Fairbanks, Alaska. His current practice location is 398 Hamilton Ave, Fairbanks, Alaska. You can reach out to his office (for appointments etc.) via phone at (907) 374-4911.

Derrick Cannon is licensed to practice in Alaska (license number PHYP2677) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1598192312.

Contact Information

	Derrick Cannon, PT, DPT
	398 Hamilton Ave, Fairbanks, AK 99701-3537
	(907) 374-4911
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Derrick Cannon
Gender	Male
Speciality	Physical Therapist
Location	398 Hamilton Ave, Fairbanks, Alaska
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598192312
Provider Enumeration Date: 10/11/2013
Last Update Date: 02/15/2017

Medicare PECOS Information:

PECOS PAC ID: 9133468267
Enrollment ID: I20210107000945

Medical Identifiers

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

Identifier	Type	State	Issuer
1598192312	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PHYP2677 (Alaska)	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. Derrick Cannon allows following entities to bill medicare on his behalf.

Provider Name	Ivyrehab Michigan Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1104337120 PECOS PAC ID: 6901165893 Enrollment ID: O20180123001245

Provider Name	Michigan Luna Care Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1003448994 PECOS PAC ID: 9032549217 Enrollment ID: O20200501000804

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 Cannon 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 Cannon, PT, DPT 398 Hamilton Ave, Fairbanks, AK 99701-3537 Ph: (907) 374-4911	Derrick Cannon, PT, DPT 398 Hamilton Ave, Fairbanks, AK 99701-3537 Ph: (907) 374-4911

Reviews and Comments

Physical Therapist in Fairbanks, AK

Tara J Scogin, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1275 Sadler Way, Suite 201, Fairbanks, AK 99701 Phone: 907-374-0992
Mrs. Johnna Renee Underwood, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 459 Farmers Loop Rd, Fairbanks, AK 99712 Phone: 907-550-0587
Susan Grace Mcdiarmid, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 751 Old Richardson Hwy, #202, Fairbanks, AK 99701 Phone: 907-455-4401 Fax: 907-455-4402
Ms. Mary Jones, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2166 Yellow Leaf Ct, Fairbanks, AK 99709 Phone: 907-455-6875
Emily Roberts Rogers, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1275 Sadler Way, Ste 201, Fairbanks, AK 99701 Phone: 907-374-0992 Fax: 907-374-0986
Elizabeth Lee Myers, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 418 3rd St Ste 1b, Fairbanks, AK 99701 Phone: 907-374-0225 Fax: 907-308-4025
Annette Freymueller, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1258 Viewpointe Dr, Fairbanks, AK 99709 Phone: 907-479-3550

Derrick Cannon, PT, DPT - Medicare Physical Therapist in Fairbanks, AK