Dr Derek Walter Nickerson, MD in San Diego, CA - Medicare Micrographic Dermatologic Surgery (mds)

Dr Derek Walter Nickerson, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in San Diego, California. He went to New York Medical College and graduated in 2016 and has 9 years of diverse experience with area of expertise as Micrographic Dermatologic Surgery (mds). He is a member of the group practice Grossmont Dermatology Medical Clinic and his current practice location is 5550 Carmel Mountain Rd, San Diego, California. You can reach out to his office (for appointments etc.) via phone at (858) 943-2540.

Dr Derek Walter Nickerson is licensed to practice in California (license number A171167) 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 1265895619.

Contact Information

	Dr Derek Walter Nickerson, MD
	5550 Carmel Mountain Rd, San Diego, CA 92130-4853
	(858) 943-2540
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Derek Walter Nickerson
Gender	Male
Speciality	Micrographic Dermatologic Surgery (mds)
Experience	9 Years
Location	5550 Carmel Mountain Rd, San Diego, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Derek Walter Nickerson attended and graduated from New York Medical College in 2016

NPI Data:

NPI Number: 1265895619
Provider Enumeration Date: 04/02/2016
Last Update Date: 05/18/2025

Medicare PECOS Information:

PECOS PAC ID: 3072888494
Enrollment ID: I20210712000833

Medical Identifiers

Medical identifiers for Dr Derek Walter Nickerson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265895619	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207ND0101X	Dermatology - Mohs-micrographic Surgery	A171167 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Grossmont Dermatology Medical Clinic	4981672342	10

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 Walter Nickerson allows following entities to bill medicare on his behalf.

Entity Name	Grossmont Dermatology Medical Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194838441 PECOS PAC ID: 4981672342 Enrollment ID: O20040922001271

Entity Name	Csi Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871909804 PECOS PAC ID: 5890916845 Enrollment ID: O20141016001930

Entity Name	Coastal Skin And Eye Institute Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790232015 PECOS PAC ID: 8224326715 Enrollment ID: O20161017001429

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 Walter Nickerson 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
Dr Derek Walter Nickerson, MD 5550 Carmel Mountain Rd, San Diego, CA 92130-4853 Ph: (858) 943-2540	Dr Derek Walter Nickerson, MD 5550 Carmel Mountain Rd, San Diego, CA 92130-4853 Ph: (858) 943-2540

Reviews and Comments

Dermatology Doctors in San Diego, CA

Dr. Stephen Erik Hemperly, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4060 Fourth Ave Ste 415, San Diego, CA 92103 Phone: 619-298-9809 Fax: 619-298-9823
Dr. Ghada K Kassab, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4606 Mission Bay Dr, San Diego, CA 92109 Phone: 858-273-2726 Fax: 858-273-2725
Dr. Vikas Shrivastava, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: Naval Medical Ctr, 34800 Bob Wilson Dr, San Diego, CA 92134 Phone: 619-251-7471
Dr. Michelle Terez Pelle, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3965 5th Ave Ste 200, San Diego, CA 92103 Phone: 619-542-0013 Fax: 619-542-0559
Dr. Jamison Derek Feramisco, MD, PHD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8898 Navajo Rd # C-349, San Diego, CA 92119 Phone: 619-650-5476
Sharon Jacob-soo, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 3860 Calle Fortunada, Ste #210, San Diego, CA 92123 Phone: 858-309-6303 Fax: 858-309-6301
Dr. Susan Boiko, MD Dermatology Medicare: Medicare Enrolled Practice Location: 8010 Frost St, Ste 602, San Diego, CA 92123 Phone: 858-966-6795

Dr Derek Walter Nickerson, MD - Medicare Micrographic Dermatologic Surgery (mds) in San Diego, CA