Mr Derek J Humphres, CRNA in Peoria, IL - Medicare Nurse Anesthetist, Certified Registered

Mr Derek J Humphres, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Peoria, Illinois. His current practice location is 6742 N Frostwood Pkwy, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 692-5393.

Mr Derek J Humphres is licensed to practice in Illinois (license number 209025607) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942981766.

Contact Information

	Mr Derek J Humphres, CRNA
	6742 N Frostwood Pkwy, Peoria, IL 61615-2402
	(309) 692-5393
	(309) 683-9998

Map and Direction

Provider's Profile

Full Name	Mr Derek J Humphres
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	6742 N Frostwood Pkwy, Peoria, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1942981766
Provider Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023

Medicare PECOS Information:

PECOS PAC ID: 6507211992
Enrollment ID: I20231004001906

Medical Identifiers

Medical identifiers for Mr Derek J Humphres such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942981766	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	209025607 (Illinois)	Primary

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. Mr Derek J Humphres allows following entities to bill medicare on his behalf.

Entity Name	Associated Anesthesiologists Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558306480 PECOS PAC ID: 6305744129 Enrollment ID: O20031230000544

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. Mr Derek J Humphres 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
Mr Derek J Humphres, CRNA 128 Justice Dr, East Peoria, IL 61611-1468 Ph: (309) 369-1543	Mr Derek J Humphres, CRNA 6742 N Frostwood Pkwy, Peoria, IL 61615-2402 Ph: (309) 692-5393

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Peoria, IL

Melissa Terhark, C.R.N.A Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 8600 North State Route 91, Suite #250, Peoria, IL 61615 Phone: 309-692-5394 Fax: 309-692-2538
Mathew J Maupin, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 5401 N. Knoxville Suite 416, Peoria, IL 61528 Phone: 309-692-7246 Fax: 309-692-7226
Sandra M Krahn, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5522
Adam Randel Osborne, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5550
Dr. Samantha Mae Aufderhaar, DNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000
Mr. Gary L Boniger, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 8600 N State Route 91, Suite 250, Peoria, IL 61615 Phone: 309-692-5393 Fax: 309-692-2538
Diana Lynn Lowe, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 8600 N State Route 91, Suite 250, Peoria, IL 61615 Phone: 309-692-5393 Fax: 309-692-2538

Mr Derek J Humphres, CRNA - Medicare Nurse Anesthetist, Certified Registered in Peoria, IL