DR. PATRICK DERBY DPM NPI 1073075222

NPI Information

NPI: 1073075222
Provider Name: DR. PATRICK DERBY, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
2511 W DR MARTIN LUTHER KING JR BLVD
TAMPA, FL
ZIP 33607
Phone: (813) 879-7850
Get Directions

DR. Patrick Derby, DPM is a foot and ankle surgery podiatrist in Tampa, FL with 5 years of experience. DR. Patrick Derby, DPM NPI is 1073075222. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2019

The provider's business location address is:

2511 W DR MARTIN LUTHER KING JR BLVD
TAMPA, FL
ZIP 33607-301
Phone: (813) 879-7850
Fax: (813) 870-3569

The NPI 1073075222 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/4/2019 and was last updated on 2/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		PO4422	FLORIDA	No
2	213EP1101X	Podiatrist	Primary Podiatric Medicine	PO4422	FLORIDA	No
3	213ES0000X	Podiatrist	Sports Medicine	PO4422	FLORIDA	No
4	213ES0131X	Podiatrist	Foot Surgery	PO4422	FLORIDA	No
5	213ES0103X	Podiatrist	Foot & Ankle Surgery	PO4422	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OPOAV	OTHER	FLORIDA	BCBS
2	7333506	OTHER	FLORIDA	CIGNA ID
3	114530400	MEDICAID	FLORIDA
4	6605657	OTHER	FLORIDA	AETNA
5	15659126	OTHER		CAQH ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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