Robert John Derby, NP - Medicare Nurse Practitioner in Beloit, WI

Robert John Derby, NP is a medicare enrolled "Nurse Practitioner" in Beloit, Wisconsin. His current practice location is Beloit Clinic, 1905 E Huebbe Parkway, Beloit, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (608) 364-1640.

Robert John Derby is licensed to practice in Wisconsin (license number 11369-33) 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 1104593060.

Contact Information

Robert John Derby, NP
Beloit Clinic, 1905 E Huebbe Parkway,
Beloit, WI 53511-1842
(608) 364-1640
(608) 363-7393



Provider's Profile

Full NameRobert John Derby
GenderMale
SpecialityNurse Practitioner
LocationBeloit Clinic, Beloit, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104593060
  • Provider Enumeration Date: 08/26/2021
  • Last Update Date: 12/04/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4183004989
  • Enrollment ID: I20231207002676

Medical Identifiers

Medical identifiers for Robert John Derby such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104593060NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 209024153 (Illinois)Secondary
363LF0000XNurse Practitioner - Family 11369-33 (Wisconsin)Secondary
363L00000XNurse Practitioner 11369-33 (Wisconsin)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. Robert John Derby allows following entities to bill medicare on his behalf.
Entity NameBeloit Health System Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841485984
PECOS PAC ID: 8224947858
Enrollment ID: O20080204000702

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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. Robert John Derby 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
Robert John Derby, NP
Beloit Health Systems Inc, 1969 W Hart Road,
Beloit, WI 53511-2230

Ph: (608) 364-2293
Robert John Derby, NP
Beloit Clinic, 1905 E Huebbe Parkway,
Beloit, WI 53511-1842

Ph: (608) 364-1640

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Nurse Practitioner Nurses in Beloit, WI

Madelene G. Hamann, N.P.
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1905 E Huebbe Pkwy, 1905 E. Huebbe Parkway, Beloit, WI 53511
Phone: 608-364-2240    Fax: 608-363-7374
R Christian Rhoads, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1768 Gateway Blvd Apt 607, Beloit, WI 53511
Phone: 815-978-0804    
Cynthia L Philpott, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511
Phone: 608-364-2400    Fax: 608-363-7389
Malissa R Wightman, RN, APNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 2825 Prairie Ave, Beloit, WI 53511
Phone: 608-363-5500    
Ms. Cindy I Damon, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1905 E Huebbe Pkwy, Beloit Health System Inc, Beloit, WI 53511
Phone: 608-364-2200    Fax: 608-363-7395
Mrs. Tammy Jo Boxleitner, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1969 West Hart Road, Beloit Memorial Hospital, Inc., Beloit, WI 53511
Phone: 608-364-5011    

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