Keith J. Derickson, MD
Family Medicine Physician · Fort Wayne, IN
Keith J. Derickson, MD is a family medicine physician with a practice address in Fort Wayne, Indiana, and NPI 1538480439, issued on Jun 15, 2010. Check the license (Indiana 01070470A, as entered in NPPES) on the Medical Licensing Board of Indiana; the Medicare figures below come from public CMS files.
- Name
- Keith J. Derickson
- Credential
- MD
- Primary taxonomy
- Family Medicine Physician 207Q00000X
- License number
- 01070470A IN
Self-reported in NPPES; status is on the state search - Practice location
- 6404 Rothman RD, Fort Wayne, IN 46835
- Phone
- (260) 486-6197
- Enumerated
- Jun 15, 2010
- Record last updated
- Sep 28, 2020 (not updated in 6 years: call before relying on the address or phone)
- Fax
- (260) 486-9862
- Medicaid ID
- 201047100 IN
- Medicare enrollment
- Enrolled (PECOS I20130724000656); accepts Medicare assignment
- Medical or professional school
- Indiana University School Of Medicine, 2010
- Telehealth
- Offers telehealth (CMS)
- Entity
- Type 1 · individual
8 nearest family medicine physician records → All 3,506 in Indiana → Look up another NPI →
Also registered at 6404 Rothman RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Patrick Holly, MDFamily Medicine Physician1811933583
Verify Keith J. Derickson in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersMedical Licensing Board of Indiana
Search for license 01070470ACheck the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
3.4 times the Medicare Part D claims of the average family medicine physician in 2024
12,012 Medicare Part D claims for 784 beneficiaries, against an average of 3,544 among the 117,163 providers of this specialty who prescribed in Part D. Brand-name drugs were 13% of claims. 296 claims were for opioids.
Most prescribed
- Atorvastatin Calcium872 claims
- Levothyroxine Sodium461 claims
- Amlodipine Besylate399 claims
- Lisinopril380 claims
- Omeprazole358 claims
- Losartan Potassium234 claims
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
The MIPS final score for 2023 (Medicare payment program): 88 of 100
The Merit-based Incentive Payment System score is reported for this clinician. Four categories are weighted into the final score; the average among 454,083 clinicians with a measured score was 83.5.
Source: CMS Quality Payment Program, MIPS performance year 2023; category weights for 2023 (qpp.cms.gov).
Industry payments in 2024: $2,775.59
167 payments; by number, the most common kind was food and beverage; the largest payer was Abbvie Inc. The 55,478 providers of this specialty with any payment received $902.55 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Bills Medicare through 2 group practices
- Fort Wayne Medical Education ProgramFort Wayne, IN
- Lutheran Medical Group LLCFort Wayne, IN
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Keith J. Derickson among 3,506 family medicine physician records in Indiana
Keith J. Derickson, MD is one of 3,506 family medicine physician records with a practice address in Indiana. 81% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2010, is newer than 66% of them.
- NPI issued2010 · 66% of these records are older, 32% newer
- In a Medicare fileYes · 81% of these records are
- In the CMS Doctors and Clinicians fileYes · 63% of these records are
- Graduated2010 · median 2005 among the 2,196 with a school on file
- Record last updated2020 · 48% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 207Q00000X and a Indiana practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
249 family medicine physician records list a practice address in Fort Wayne
They are 249 of the 9,203 NPPES records with a practice address in Fort Wayne, and 3,506 family medicine physician records in Indiana.
All 3,506 in Indiana → Every provider in Fort Wayne → Family Medicine Physician nationwide →
The 8 family medicine physician records with the nearest ZIP codes
- Emily Bushey, DOFort Wayne, IN 468351609281682
- Patrick Holly, MDFort Wayne, IN 468351811933583
- Gerald Kelty, M.D.Fort Wayne, IN 468351700991320
- Joshua Kline, M.D.Fort Wayne, IN 468351184615841
- Yekaterina Neichtadt Hoon, DOFort Wayne, IN 468351275194250
- Amanda Patch, M.D.Fort Wayne, IN 468351891060075
- Trever Vanderhorst, MDFort Wayne, IN 468351144635145
- Gabrielle Acquaro, M.D.Fort Wayne, IN 468251649625104
Common questions
What is Keith J. Derickson, MD's NPI number?
Keith J. Derickson, MD's National Provider Identifier (NPI) is 1538480439, issued on Jun 15, 2010. An NPI identifies a provider in billing; it is not a license.
Where is Keith J. Derickson, MD located?
The NPPES record lists a practice address at 6404 Rothman RD, Fort Wayne, IN, 46835. Phone: (260) 486-6197. Providers update this record themselves, so call before visiting.
How can I verify Keith J. Derickson, MD's license?
NPPES lists Indiana license number 01070470A, as entered by the provider. Search the Medical Licensing Board of Indiana at https://www.in.gov/pla/professions/physicians-home/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
How much does Keith J. Derickson, MD prescribe under Medicare Part D?
In 2024, Keith J. Derickson, MD had 12,012 Medicare Part D claims for 784 beneficiaries; the average among family medicine physician prescribers was 3,544. Part D covers Medicare prescriptions only.
What is Keith J. Derickson, MD's MIPS final score?
The 2023 MIPS final score is 88 of 100. The average among 454,083 clinicians with a measured score was 83.5.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.