Dr Derek Anthony Mclister, DPM is a medicare enrolled "Podiatrist" physician in Fargo, North Dakota. He went to Des Moines University Of Osteopathic Medicine And Health Sciences and graduated in 2017 and has 7 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Sanford Medical Center Fargo and his current practice location is
5225 23rd Ave S, Fargo, North Dakota. You can reach out to his office (for appointments etc.) via phone at
(701) 417-2575.
Dr Derek Anthony Mclister is licensed to practice in Minnesota (license number 1068) 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 1114453552.
Physician's Profile
| Full Name | Dr Derek Anthony Mclister |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 7 Years |
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| Location | 5225 23rd Ave S, Fargo, North Dakota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Derek Anthony Mclister attended and graduated from Des Moines University Of Osteopathic Medicine And Health Sciences in 2017
NPI Data:
- NPI Number: 1114453552
- Provider Enumeration Date: 05/04/2017
- Last Update Date: 04/04/2022
Medicare PECOS Information:
- PECOS PAC ID: 9032537873
- Enrollment ID: I20200910003348
Medical Identifiers
Medical identifiers for Dr Derek Anthony Mclister such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1114453552 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207XX0004X | Orthopaedic Surgery - Foot And Ankle Surgery | 86 (North Dakota) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (North Dakota) | Secondary |
| 213E00000X | Podiatrist | 1068 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Sanford Medical Center Fargo | 8426967803 | 1094 |
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. Dr Derek Anthony Mclister allows following entities to bill medicare on his behalf.
| Entity Name | Sanford Clinic North |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942241351
PECOS PAC ID: 4284546151
Enrollment ID: O20031112000221 |
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| Entity Name | Sanford Medical Center Fargo |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184917924
PECOS PAC ID: 8426967803
Enrollment ID: O20110331000495 |
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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. Dr Derek Anthony Mclister 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 |
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Dr Derek Anthony Mclister, DPM
Po Box 5074,
Sioux Falls, SD 57117-5074
Ph: () - | Dr Derek Anthony Mclister, DPM
5225 23rd Ave S,
Fargo, ND 58104-7927
Ph: (701) 417-2575 |
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