Derek Donovan, PA-C is a
Physician Assistant based in Moodus, Connecticut. Derek Donovan is licensed to practice in Connecticut (license number 003652) and his current practice location is
27 William F Palmer Rd, Moodus, Connecticut. He can be reached at his office (for appointments etc.) via phone at
(860) 873-1414.
NPI number for Derek Donovan is 1417324930 and his current mailing address is 28 Crescent St, Middletown, Connecticut. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417324930.
Provider's Profile
| Full Name | Derek Donovan |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 27 William F Palmer Rd, Moodus, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417324930
- Provider Enumeration Date: 09/01/2015
- Last Update Date: 04/12/2017
Medical Identifiers
Medical identifiers for Derek Donovan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417324930 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | 0010-05911 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 003652 (Connecticut) | Primary |
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 Donovan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Derek Donovan, PA-C 28 Crescent St, Middletown, CT 06457-3654 Ph: (860) 358-4820 | Derek Donovan, PA-C 27 William F Palmer Rd, Moodus, CT 06469-1132 Ph: (860) 873-1414 |
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