Doctor profile · Federal record
Dr. Keith Derickson, MD
Family Medicine Physician (CMS: Family Practice) · Fort Wayne, IN
- NPI 1538480439
- Accepts Medicare
- MIPS 87.0 / 100 · 2023
- 16 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
6404 Rothman RD
Fort Wayne, IN 468351366
(260) 486-6197
fax (260) 486-9862 - Mailing address
-
6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 468047934
Credentials & registration
- NPI registered
- June 2010 — 16 yrs on file
- Profile last updated
- September 28, 2020
- Year of graduation
- 2010 — 16 yrs since
- Specialty taxonomy
- 207Q00000X — NUCC code
- State license (1)
- Indiana #01070470A
- Medicaid
- IN #201047100
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1538480439. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
1,118
Distinct HCPCS
10
Medicare allowed
$81,536
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 261 | 168 | $118 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 183 | 123 | $83 | |
G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 149 | 149 | $121 | |
83036 |
Hemoglobin a1c level | 79 | 48 | $9 | |
36415 |
Insertion of needle into vein for collection of blood sample | 65 | 59 | $8 | |
J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 62 | 11 | $1 | |
99232 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 43 | 23 | $66 | |
80061 |
Blood test, lipids (cholesterol and triglycerides) | 40 | 40 | $13 | |
G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 31 | 31 | $153 | |
G0008 |
Administration of influenza virus vaccine | 25 | 25 | $29 |
In context: peer comparison
Among 81 peers in this city , average services per provider: 68. This provider delivers 16× the peer median.Open Payments
Industry payments received
All-time total
$2,776
Transactions
149
Manufacturers
15
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| ABBVIE INC. | 48 | $551.46 | |
| Novo Nordisk Inc | 17 | $298.69 | |
| AstraZeneca Pharmaceuticals LP | 7 | $256.52 | |
| Lilly USA, LLC | 13 | $220.40 | |
| PFIZER INC. | 16 | $205.52 | |
| Tris Pharma Inc | 11 | $173.59 | |
| Bayer Healthcare Pharmaceuticals Inc. | 9 | $172.32 | |
| Alnylam Pharmaceuticals Inc. | 4 | $115.57 | |
| Lundbeck LLC | 5 | $100.66 | |
| Axsome Therapeutics, Inc. | 4 | $88.03 | |
| Takeda Pharmaceuticals U.S.A., Inc. | 5 | $82.96 | |
| Sumitomo Pharma America, Inc. | 3 | $62.97 | |
| Astellas Pharma US Inc | 3 | $59.84 | |
| Abbott Laboratories | 2 | $42.02 | |
| Xeris Pharmaceuticals, Inc. | 2 | $38.57 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
3,932
Patients
1,146
Total drug cost
$45,280
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Atorvastatin Calcium | Generic | 765 | 225 | $8,230 |
| Levothyroxine Sodium | Generic | 431 | 117 | $6,602 |
| Lisinopril | Generic | 384 | 103 | $2,057 |
| Amlodipine Besylate | Generic | 374 | 107 | $1,770 |
| Omeprazole | Generic | 303 | 85 | $3,560 |
| Gabapentin | Generic | 196 | 58 | $4,339 |
| Losartan Potassium | Generic | 194 | 64 | $2,489 |
| Lisinopril-Hydrochlorothiazide (Lisinopril/Hydrochlorothiazide) | Brand | 191 | 56 | $1,971 |
| Metformin Hcl Er (Metformin Hcl) | Brand | 171 | 51 | $1,854 |
| Tamsulosin Hcl | Generic | 166 | 56 | $4,172 |
Hospital affiliations
Frequently asked questions
What is Dr. Keith Derickson's medical specialty?
Dr. Keith Derickson practices Family Medicine Physician in Fort Wayne, IN.
Where does Dr. Keith Derickson practice?
Dr. Keith Derickson practices at 6404 Rothman RD, Fort Wayne, IN 468351366. Office phone: 2604866197.
What is Dr. Keith Derickson's NPI?
Dr. Keith Derickson's National Provider Identifier (NPI) is 1538480439, issued by NPPES.
Does Dr. Keith Derickson accept Medicare assignment?
Yes. Dr. Keith Derickson accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Keith Derickson commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99214); Established patient office or other outpatient visit (HCPCS 99213); Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS G0439). Source: CMS Medicare Physician & Other Practitioners file.