Dr Derek Koller, MD - Medicare Family Practice in Salem, OR

Dr Derek Koller, MD is a medicare enrolled "Family Medicine" physician in Salem, Oregon. He went to University Of Texas Medical School At San Antonio and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Doctor On Demand Professionals Of California and his current practice location is 6861 Lemongrass Loop Se, Salem, Oregon. You can reach out to his office (for appointments etc.) via phone at (361) 902-4789.

Dr Derek Koller is licensed to practice in Hawaii (license number 17981) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1629338470.

Contact Information

Dr Derek Koller, MD
6861 Lemongrass Loop Se,
Salem, OR 97306-1474
(361) 902-4789
(361) 902-4588

Map and Direction




Physician's Profile

Full NameDr Derek Koller
GenderMale
SpecialityFamily Practice
Experience12 Years
Location6861 Lemongrass Loop Se, Salem, Oregon
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Derek Koller attended and graduated from University Of Texas Medical School At San Antonio in 2012
  NPI Data:
  • NPI Number: 1629338470
  • Provider Enumeration Date: 05/25/2012
  • Last Update Date: 01/13/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 0941519383
  • Enrollment ID: I20200401002517

Medical Identifiers

Medical identifiers for Dr Derek Koller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629338470NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 284778 (New York)Secondary
207Q00000XFamily Medicine M-14141 (Idaho)Secondary
207Q00000XFamily Medicine MED-PHYS-LIC-60886 (Montana)Secondary
207Q00000XFamily Medicine A143337 (California)Secondary
207Q00000XFamily Medicine DR.0059780 (Colorado)Secondary
207Q00000XFamily Medicine MD60818224 (Washington)Secondary
207Q00000XFamily Medicine MD186008 (Oregon)Secondary
207Q00000XFamily Medicine MD2018-0164 (New Mexico)Secondary
207Q00000XFamily Medicine 17828 (Nevada)Secondary
207Q00000XFamily Medicine 11453A (Wyoming)Secondary
207Q00000XFamily Medicine 55553 (Arizona)Secondary
207Q00000XFamily Medicine S2376 (Texas)Secondary
207Q00000XFamily Medicine ME142837 (Florida)Secondary
207Q00000XFamily Medicine 036151000 (Illinois)Secondary
207Q00000XFamily Medicine 17981 (Hawaii)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Doctor On Demand Professionals Of California640616153822

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 Koller allows following entities to bill medicare on his behalf.
Entity NameDoctor On Demand Professionals Of California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346658614
PECOS PAC ID: 6406161538
Enrollment ID: O20180216001603

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 Koller 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
Dr Derek Koller, MD
6861 Lemongrass Loop Se,
Salem, OR 97306-1474

Ph: (361) 902-4789
Dr Derek Koller, MD
6861 Lemongrass Loop Se,
Salem, OR 97306-1474

Ph: (361) 902-4789

Reviews and Comments


Family Medicine Doctors in Salem, OR

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Mark Joseph Scherlie, DO
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Practice Location: 1275 Wallace Rd Nw, Salem, OR 97304
Phone: 503-371-3232    Fax: 503-375-2398

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.