Active NPI 1396217485 Individual Practitioner Male Practitioner

Derick Stackpole

Physician Assistant • Roanoke, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Derick Stackpole is a certified Physician Assistant practicing in Roanoke, VA. With approximately 8 years of clinical experience since completing medical education in 2018, Derick Stackpole delivers high-quality medical care to the local community at 4035 ELECTRIC RD STE A.

Derick Stackpole maintains professional affiliations with Carilion Emergency Services Inc, Carilion Healthcare Corporation and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, emergency department visit with low level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4035 Electric Rd Ste A

Roanoke, VA 24018

Telephone 5407728670

Associated Practice Facility / Clinic

🏢 Carilion Dtc Services Inc Facility NPI 1235801598

Medicare Profile & Education

Medical School

Other

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roanoke, VA

Experienced Practitioner (5-10 Yrs)

Practitioner Clinical Experience

8 Yrs -0.4 yrs vs City Avg

City Avg: 8.4 Yrs

State Avg: 10.5 Yrs

Regional Practice Density

301 Specialists

Practicing in Roanoke, VA (4432 Statewide)

Telehealth Adoption Rate

13.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

75.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stackpole (8 Years) 8 Yrs

Roanoke Specialty Average (8.4 Years) 8.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	61	60	$600.00	$140.31
99284 Emergency department visit with moderate level of medical decision making	17	17	$368.00	$97.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	106	102	$600.00	$145.65
99284 Emergency department visit with moderate level of medical decision making	45	45	$368.00	$98.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	117	113	$465.38	$147.24
99284 Emergency department visit with moderate level of medical decision making	60	59	$294.67	$102.93
99283 Emergency department visit with low level of medical decision making	31	31	$163.58	$60.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	154	151	$425.00	$151.57
99284 Emergency department visit with moderate level of medical decision making	70	69	$280.00	$104.39
99283 Emergency department visit with low level of medical decision making	37	36	$151.00	$61.45

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	111	109	$297.00	$92.84
99213 Established patient office or other outpatient visit, typically 15 minutes	109	107	$155.00	$64.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$155.00	$91.94
71046 X-ray of chest, 2 views	41	41	$63.24	$27.87
81003 Automated urinalysis test	37	37	$45.00	$2.24
93000 Routine ekg using at least 12 leads including interpretation and report	25	25	$45.00	$14.55
J1885 Injection, ketorolac tromethamine, per 15 mg	22	12	$10.00	$0.58
87804 Detection test by immunoassay with direct visual observation for influenza virus	22	11	$45.00	$16.46
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	15	$45.00	$12.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$297.00	$140.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	28	28	$155.00	$62.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	23	$297.00	$91.34
81003 Automated urinalysis test	11	11	$45.00	$2.44

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License VA 0110006532

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.

Hospital & Practice Group Affiliations

Carilion Healthcare Corporation

1955 W Main St, Salem, VA 241533109

Phone: 5403870441

Carilion Healthcare Corporation

1935 W Main St, Salem, VA 241533109

Phone: 5403870441

Carilion Emergency Services Inc

13205 Booker T Washington Hwy, Hardy, VA 241013947

Phone: 5407191815

Carilion Emergency Services Inc

434 Peppers Ferry Nw Rd, Christiansburg, VA 240735780

Phone: 5403826000

Carilion Healthcare Corporation

6415 Peters Creek Rd, Roanoke, VA 240194021

Phone: 7035622110

Carilion Emergency Services Inc

46 Wesley Rd, Daleville, VA 240833082

Phone: 5405919440

Secondary Practice Locations

1906 Belleview Ave Se

Roanoke, VA 240141838

Phone: 5403149194

Practice Associates & Co-Workers

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

33 Associated Practitioners

Brittany Kendrick , FNP-C

Nurse Practitioner - Family

NPI 1023745817

Family Nurse Practitioner (Certified)

Jennifer Mitchell , FNP-C

Nurse Practitioner - Family

NPI 1033075239

Family Nurse Practitioner (Certified)

Melissa Swihart , PA-C

Physician Assistant

NPI 1033623772

Physician Assistant (Certified)

Philip Furrow , PA-C

Physician Assistant

NPI 1043555022

Physician Assistant (Certified)

Jessica Dillon , FNP-C

Nurse Practitioner - Family

NPI 1053011841

Family Nurse Practitioner (Certified)

Ann Hutchens

Nurse Practitioner - Family

NPI 1073475638

Career & Practice History Timeline

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

9 Historical Events

📍

Updated Practice Location August 29, 2019

Registered at 4035 ELECTRIC RD STE A, ROANOKE, VA 24018 (Tel: 5407728670)

📍

Updated Business Mailing Address August 29, 2019

Registered at 4035 ELECTRIC RD STE A, ROANOKE, VA 240188449 (Tel: 5407728670)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2019

Physician Assistant (License #0110006532 in VA)

✅

NPI Profile Active December 30, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location December 30, 2018

Registered at 1906 BELLEVIEW AVE SE, ROANOKE, VA 240141838 (Tel: 5403149194)

📍

Updated Business Mailing Address December 30, 2018

Registered at 618 MOUNTAIN AVE SW, ROANOKE, VA 240163838 (Tel: 5403149194)

👤

Provider Name / Credentials Updated December 30, 2018

Recorded as DERICK STACKPOLE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2018

Physician Assistant

🟢

Initial NPI Registration & Enumeration December 30, 2018

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: 1396217485

Entity Type:

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

Enumeration Date: December 30, 2018

Last Update: August 29, 2019

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4035 Electric Rd Ste A

Roanoke, VA 240188449

Phone: 5407728670

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.