Active NPI 1417324930 Individual Practitioner Male Practitioner

Derek Donovan , PA-C

Physician Assistant • Moodus, CT

Professional Overview & Biography Verified Profile Summary

Derek Donovan, PA-C is a registered healthcare professional specializing in Physician Assistant in Moodus, CT. Practice services are available at 27 WILLIAM F PALMER RD under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

27 William F Palmer Rd

Moodus, CT 064691132

Telephone 8608731414

Fax 8603588659

Associated Practice Facility / Clinic

🏢 Mhs Primary Care Inc Facility NPI 1811322951

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Moodus, CT

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 11.2 Yrs

Regional Practice Density

1 Specialists

Practicing in Moodus, CT (2065 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

49.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	23	$233.00	$114.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$374.00	$148.86
G0008 Administration of influenza virus vaccine	13	13	$40.00	$32.50
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	13	13	$71.68	$70.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	44	$265.13	$120.43
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	39	37	$150.00	$51.31
99213 Established patient office or other outpatient visit, typically 15 minutes	29	29	$175.00	$84.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$452.00	$155.43
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$293.00	$104.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	69	53	$224.17	$99.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$289.38	$101.31
99213 Established patient office or other outpatient visit, typically 15 minutes	35	35	$174.29	$70.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	283	108	$220.00	$98.58
99213 Established patient office or other outpatient visit, typically 15 minutes	75	49	$170.00	$68.61
36415 Insertion of needle into vein for collection of blood sample	50	37	$22.00	$2.82
G0008 Administration of influenza virus vaccine	43	43	$46.00	$17.96
90662 Influenza vaccine split virus, preservative free	39	39	$74.00	$54.49
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$194.00	$107.49
81003 Automated urinalysis test	13	11	$16.00	$2.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	286	116	$202.87	$98.10
99213 Established patient office or other outpatient visit, typically 15 minutes	67	45	$178.48	$66.65
36415 Insertion of needle into vein for collection of blood sample	47	37	$22.00	$2.94
G0008 Administration of influenza virus vaccine	33	32	$46.00	$22.26
90662 Influenza vaccine split virus, preservative free	26	25	$73.23	$51.48
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	20	20	$190.75	$106.71
81003 Automated urinalysis test	16	13	$15.63	$2.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	589	196	$189.00	$97.95
36415 Insertion of needle into vein for collection of blood sample	131	87	$22.00	$2.93
G0008 Administration of influenza virus vaccine	44	43	$46.00	$27.77
90662 Influenza vaccine split virus, preservative free	33	33	$70.00	$48.05
99213 Established patient office or other outpatient visit, typically 15 minutes	31	26	$155.65	$67.06
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$189.00	$105.69
81003 Automated urinalysis test	17	15	$15.00	$3.02
93000 Routine ekg using at least 12 leads including interpretation and report	15	15	$95.00	$15.71
83036 Hemoglobin A1C level	15	11	$30.00	$13.05
69210 Removal of impacted ear wax	14	13	$170.00	$43.64
99496 Transitional care management services for problem of high complexity	14	12	$491.00	$210.73
99495 Transitional care management services for problem of at least moderate complexity	11	11	$352.00	$149.12

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License CT 003652

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License NC 0010-05911

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Daniel Henriquez , MD

Family Medicine

NPI 1326573072

Doctor of Medicine (M.D.)

Dr. Eric Fisher , DO

Family Medicine

NPI 1730190034

Doctor of Osteopathic Medicine (D.O.)

Dr. Malcolm Gourlie , MD

Family Medicine

NPI 1912966219

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active April 12, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 12, 2017

Registered at 27 WILLIAM F PALMER RD, MOODUS, CT 064691132 (Tel: 8608731414)

📍

Updated Business Mailing Address April 12, 2017

Registered at 28 CRESCENT ST, MIDDLETOWN, CT 064573654 (Tel: 8603584820)

👤

Provider Name / Credentials Updated April 12, 2017

Recorded as DEREK DONOVAN, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 12, 2017

Physician Assistant (License #0010-05911 in NC)

✅

NPI Profile Active October 19, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location October 19, 2016

Registered at 27 WILLIAM F PALMER RD, MOODUS, CT 064691132 (Tel: 8608731414)

📍

Updated Business Mailing Address October 19, 2016

Registered at 28 CRESCENT ST, MIDDLETOWN, CT 064573654 (Tel: 8603584820)

👤

Provider Name / Credentials Updated October 19, 2016

Recorded as DEREK DONOVAN, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2016

Physician Assistant (License #003652 in CT)

🟢

Initial NPI Registration & Enumeration September 01, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417324930

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 01, 2015

Last Update: April 12, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

28 Crescent St

Middletown, CT 064573654

Phone: 8603584820

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.