Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Derek Ryan Roberts , PA-C

Physician Assistant β€’ Maxwell Afb, AL

Active NPI 1821426362 Individual Practitioner Male Practitioner
Practice location in NPPES

300 Twining St
Maxwell Afb, AL 361126027

Call 3349533368 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

300 Twining St

Maxwell Afb, AL 361126027

Telephone 3349533368
Organization at the Same NPPES Address or Phone
42d Medgrp-Maxwell Facility NPI 1487053435

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2013

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Maxwell Afb and Alabama

8 active clinicians are listed under Physician Assistant with a practice address in Maxwell Afb, AL (1,148 in Alabama).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-07-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES FL PA9111316

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES WV 617

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES OH 50.003912

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Alabama State Board of Medical Examiners.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Hawaii Physician Assistant License
AMD-666 (HI)
Other Identifier Wv Physician Assistant License
1772 (WV)
Other Identifier Ohio License
50.003912 (OH)
Other Identifier Physician Assistant
PA9111316 (FL)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Lauren Candee , PA-C

Physician Assistant - Medical

NPI 1720473754

Physician Assistant (Certified)

Paula Giamo , PA-C

Physician Assistant

NPI 1427233154

Physician Assistant (Certified)

Eric Korzen , PA-C

Physician Assistant

NPI 1275777948

Physician Assistant (Certified)

Dr. Benjamin Schmitt , DPT

Physical Therapist

NPI 1750945796

Doctor of Physical Therapy

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

14 Historical Events
πŸ“
Updated Practice Location July 15, 2024

Registered at 300 TWINING ST, MAXWELL AFB, AL 361126027 (Tel: 3349533368)

πŸ“
Updated Business Mailing Address July 15, 2024

Registered at 300 TWINING ST, MAXWELL AFB, AL 361126027

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2024

Physician Assistant (license number reported to NPPES: FL PA9111316)

βœ…
NPI Profile Active February 10, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location February 10, 2017

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302 (Tel: 8508838600)

πŸ“
Updated Business Mailing Address February 10, 2017

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302 (Tel: 8508838600)

πŸ‘€
Provider Name / Credentials Updated February 10, 2017

Recorded as DEREK ROBERTS, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 10, 2017

Physician Assistant (license number reported to NPPES: WV 617)

βœ…
NPI Profile Active October 18, 2013

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 18, 2013

Registered at 2828 1ST AVE, SUITE 400, HUNTINGTON, WV 257021236 (Tel: 3045256905)

πŸ“
Business Mailing Address (Initial Record) October 18, 2013

Registered at 2828 1ST AVE, SUITE 400, HUNTINGTON, WV 257021236 (Tel: 3045256905)

πŸ‘€
Provider Name / Credentials (Initial Record) October 18, 2013

Recorded as DEREK ROBERTS, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 18, 2013

Physician Assistant (license number reported to NPPES: OH 50.003912)

🟒
Initial NPI Registration & Enumeration October 18, 2013

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1821426362
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2013
Last Update: July 15, 2024
Sole Proprietor: No

Other Physician Assistants in Maxwell Afb

Mailing Address

300 Twining St

Maxwell Afb, AL 361126027

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.