Dr Derry Dean Dye Jr, MD - Medicare Pediatrics in Poplar Bluff, MO

Dr Derry Dean Dye Jr, MD is a medicare enrolled "Pediatrics" physician in Poplar Bluff, Missouri. His current practice location is 225 Physicians Park Ste 400, Poplar Bluff, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 727-5500.

Dr Derry Dean Dye Jr is licensed to practice in Missouri (license number R5G11) 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 1215949599.

Contact Information

Dr Derry Dean Dye Jr, MD
225 Physicians Park Ste 400,
Poplar Bluff, MO 63901-3923
(573) 727-5500
(573) 727-5599



Physician's Profile

Full NameDr Derry Dean Dye Jr
GenderMale
SpecialityPediatrics
Location225 Physicians Park Ste 400, Poplar Bluff, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1215949599
  • Provider Enumeration Date: 08/13/2006
  • Last Update Date: 02/09/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6002726940
  • Enrollment ID: I20190829000171

Medical Identifiers

Medical identifiers for Dr Derry Dean Dye Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215949599NPI-NPPES
202400024MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice R5G11 (Missouri)Secondary
208000000XPediatrics R5G11 (Missouri)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. Dr Derry Dean Dye Jr allows following entities to bill medicare on his behalf.
Entity NameSaint Francis Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356304489
PECOS PAC ID: 9931007929
Enrollment ID: O20040107000140

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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 Derry Dean Dye Jr 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 Derry Dean Dye Jr, MD
Po Box 801143,
Kansas City, MO 64180-1143

Ph: (573) 331-5583
Dr Derry Dean Dye Jr, MD
225 Physicians Park Ste 400,
Poplar Bluff, MO 63901-3923

Ph: (573) 727-5500

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Pediatrics Doctors in Poplar Bluff, MO

Dr. Rangsan Suvan, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 2500 Lucy Lee Parkway, Poplar Bluff, MO 63901
Phone: 573-686-2585    Fax: 573-686-4415
Dr. Claudia Karin Preuschoff, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-727-5500    Fax: 573-727-5599
Gift Adanma Onyenso, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-727-5500    Fax: 573-727-5599
Dr. Debra Ann Robertson, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-727-5500    Fax: 573-727-5599
Mr. Joseph P Fernando, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 2340 Katy Ln, Suite 120, Poplar Bluff, MO 63901
Phone: 573-776-7393    Fax: 573-776-7396
Dr. Shaun A Ross, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-727-5500    Fax: 573-727-5599
Roger Kingsley Bost, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 686 Lester St, Poplar Bluff, MO 63901
Phone: 573-686-2411    Fax: 573-686-8452

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