Madeline Derting
Physician Assistant in Oklahoma City, OK. Individual provider (NPI-1).
NPI number1124846480
StatusActive
Last updated in NPPESOct 28, 2025
Details
- NPI
- 1124846480
- Entity type
- Individual (NPI-1)
- Name
- Madeline Derting
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2024
- Certification date
- Oct 28, 2025
- Last updated
- Oct 28, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5638 | OK | Yes |
Practice location
700 Ne 10th StOklahoma City, OK 73104-5404
Phone 405-271-3635
Mailing address
910 W Hill StOklahoma City, OK 73118-7257
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 685 Physician Assistant providers in Oklahoma City · All 27,799 providers in Oklahoma City
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