Derek S Versalle, DO - Medicare Emergency Medicine in Portage, MI

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Derek S Versalle, DO is a medicare enrolled "Emergency Medicine" physician in Portage, Michigan. He went to Michigan State University College Of Osteopathic Medicine and graduated in 2023 and has 3 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Southwestern Michigan Emergency Services, Pc and his current practice location is 950 Trade Centre Way, Portage, Michigan. You can reach out to his office (for appointments etc.) via phone at (269) 370-1824.

Derek S Versalle is licensed to practice in Michigan (license number 5151016178) 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 1669162616.

Contact Information

Derek S Versalle, DO
950 Trade Centre Way,
Portage, MI 49002-0487
(269) 370-1824
Not Available

Map and Direction




Physician's Profile

Full NameDerek S Versalle
GenderMale
SpecialityEmergency Medicine
Experience3 Years
Location950 Trade Centre Way, Portage, Michigan
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Derek S Versalle attended and graduated from Michigan State University College Of Osteopathic Medicine in 2023
  NPI Data:
  • NPI Number: 1669162616
  • Provider Enumeration Date: 05/12/2023
  • Last Update Date: 07/29/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 3678939279
  • Enrollment ID: I20260203001476

Medical Identifiers

Medical identifiers for Derek S Versalle such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669162616NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 5151016178 (Michigan)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southwestern Michigan Emergency Services, Pc145626589169

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. Derek S Versalle allows following entities to bill medicare on his behalf.
Entity NameSouthwestern Michigan Emergency Services, PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013021310
PECOS PAC ID: 1456265891
Enrollment ID: O20040211000832

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. Derek S Versalle 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 AddressPractice Location Address
Derek S Versalle, DO
950 Trade Centre Way Ste 230,
Portage, MI 49002-0492

Ph: Not Available		Derek S Versalle, DO
950 Trade Centre Way,
Portage, MI 49002-0487

Ph: (269) 370-1824

Reviews and Comments


Emergency Medicine Doctors in Portage, MI

Miss Francesca Rose Mcqueen, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 7901 Angling Rd, Portage, MI 49024
Phone: 269-226-5962    Fax: 214-648-8423

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.