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Derick Stackpole

Physician Assistant โ€ข Roanoke, VA

Active NPI 1396217485 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

4035 Electric Rd Ste A
Roanoke, VA 24018

Call 5407728670 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

4035 Electric Rd Ste A

Roanoke, VA 24018

Telephone 5407728670
Organization at the Same NPPES Address or Phone
Carilion Dtc Services Inc Facility NPI 1235801598

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

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Roanoke, VA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 2 distinct group names: Carilion Emergency Services Inc; Carilion Healthcare Corporation. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2018

Medicare patients

86 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $10,223 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $7,741 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

23 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$71 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021โ€“2025.

Guide: How to read an Open Payments record

Years since graduation

8 years (graduated 2018)

CMS Doctors and Clinicians data list 2018 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2018

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.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

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, โ€œDoes your provider accept Medicare as full payment?โ€

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

Enrolled in Medicare (PECOS)

Derick Stackpole has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Derick Stackpole as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Roanoke and Virginia

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Fewer Medicare Part B services than 70% of clinicians listed under Physician Assistant in Roanoke, VA (2024, 140 clinicians with data). Median for this group: 202. Middle half: 67 to 452.

Fewer Medicare Part B services than 80% of clinicians listed under Physician Assistant in Virginia (2024, 2,247 clinicians with data). Median for this group: 288. Middle half: 107 to 693.

Medicare-allowed amount

A lower Medicare-allowed amount than 65% of clinicians listed under Physician Assistant in Roanoke, VA (2024, 140 clinicians with data). Median for this group: $17,702. Middle half: $6,499 to $31,935.

A lower Medicare-allowed amount than 70% of clinicians listed under Physician Assistant in Virginia (2024, 2,247 clinicians with data). Median for this group: $23,153. Middle half: $9,003 to $44,800.

Paid by Medicare

A lower Medicare payment amount than 65% of clinicians listed under Physician Assistant in Roanoke, VA (2024, 140 clinicians with data). Median for this group: $12,849. Middle half: $4,827 to $23,492.

A lower Medicare payment amount than 70% of clinicians listed under Physician Assistant in Virginia (2024, 2,247 clinicians with data). Median for this group: $17,218. Middle half: $6,803 to $32,639.

Medicare Part D prescriptions

Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Roanoke, VA (2024, 127 clinicians with data). Median for this group: 237. Middle half: 69 to 681.

Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Virginia (2024, 2,256 clinicians with data). Median for this group: 247. Middle half: 75 to 708.

Part D drug cost

A lower Part D drug cost than 95% of clinicians listed under Physician Assistant in Roanoke, VA (2024, 127 clinicians with data). Median for this group: $3,519. Middle half: $465 to $62,513.

A lower Part D drug cost than 95% of clinicians listed under Physician Assistant in Virginia (2024, 2,256 clinicians with data). Median for this group: $3,441. Middle half: $640 to $57,211.

299 active clinicians are listed under Physician Assistant with a practice address in Roanoke, VA (4,411 in Virginia).

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

Telehealth indicator in Roanoke

13% of these 299 clinicians have the CMS telehealth indicator.

55.5% of these 299 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2018โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2019โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit with high level of medical decision making
61 60 $600.00 $140.31
99284 Emergency department visit with moderate level of medical decision making
17 17 $368.00 $97.89

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Oxycodone Hcl Oxycodone Hcl 12 29 $19.62 12
Doxycycline Hyclate Doxycycline Hyclate 11 72 $51.48 11

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES VA 0110006532

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: Virginia Department of Health Professions.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20190326002432

Enrollment State Jurisdiction

VA

PECOS Control ID

7911247119

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Carilion Healthcare Corporation

1955 W Main St, Salem, VA 241533109

Phone: 5403870441

Carilion Healthcare Corporation

1935 W Main St, Salem, VA 241533109

Phone: 5403870441

Carilion Emergency Services Inc

13205 Booker T Washington Hwy, Hardy, VA 241013947

Phone: 5407191815

Carilion Emergency Services Inc

434 Peppers Ferry Nw Rd, Christiansburg, VA 240735780

Phone: 5403826000

Carilion Healthcare Corporation

6415 Peters Creek Rd, Roanoke, VA 240194021

Phone: 7035622110

Carilion Emergency Services Inc

46 Wesley Rd, Daleville, VA 240833082

Phone: 5405919440

Secondary Practice Locations

1906 Belleview Ave Se

Roanoke, VA 240141838

Phone: 5403149194

Clinicians Sharing This Practice Address or Phone

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

23 listed
Dr. Jessica Atkins , DNP, FNP-BC

Nurse Practitioner - Family

NPI 1215691563

Doctor of Nursing Practice, Family Nurse Practitioner (Board Certified)

Jaimie Ball , FNP-C

Nurse Practitioner - Family

NPI 1093281461

Family Nurse Practitioner (Certified)

Lerena Barrett , NP

Nurse Practitioner - Family

NPI 1396420303

Nurse Practitioner

NPI 1518386283

Doctor of Medicine (M.D.)

Amber Clary , NP

Nurse Practitioner - Family

NPI 1912669086

Nurse Practitioner

Dr. Joseph Coates , MD

Family Medicine

NPI 1811108913

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

9 Historical Events
๐Ÿ“
Updated Practice Location August 29, 2019

Registered at 4035 ELECTRIC RD STE A, ROANOKE, VA 24018 (Tel: 5407728670)

๐Ÿ“
Updated Business Mailing Address August 29, 2019

Registered at 4035 ELECTRIC RD STE A, ROANOKE, VA 240188449 (Tel: 5407728670)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2019

Physician Assistant (license number reported to NPPES: VA 0110006532)

โœ…
NPI Profile Active December 30, 2018

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) December 30, 2018

Registered at 1906 BELLEVIEW AVE SE, ROANOKE, VA 240141838 (Tel: 5403149194)

๐Ÿ“
Business Mailing Address (Initial Record) December 30, 2018

Registered at 618 MOUNTAIN AVE SW, ROANOKE, VA 240163838 (Tel: 5403149194)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) December 30, 2018

Recorded as DERICK STACKPOLE

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2018

Physician Assistant

๐ŸŸข
Initial NPI Registration & Enumeration December 30, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1396217485
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 30, 2018
Last Update: August 29, 2019
Sole Proprietor: No

Other Physician Assistants in Roanoke

All Physician Assistants in Roanoke

Mailing Address

4035 Electric Rd Ste A

Roanoke, VA 240188449

Phone: 5407728670

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.