Dr. Derrick Lee Goubeaux

D.O. | Pediatric Hematology-Oncology | Male

---

Complete Profile:

Dr. Derrick Lee Goubeaux basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics, Pediatric Hematology-Oncology
Provider Name :	Dr. Derrick Lee Goubeaux
Credential :	D.O.
Gender :	Male

Business Address:

Dr. Derrick Lee Goubeaux address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	705 Riley Hospital Dr Indianapolis, IN, 46202-5109 United States
Phone Number :	317-944-2143

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1770825382
NPI Entity Type :	Individual
First Enrolment Date :	21 Mar, 2013
Last Updated On :	24 Mar, 2023

Medicare Participation:

Dr. Derrick Lee Goubeaux participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	3678715539
Medicare Enrollment ID :	I20220713000289
Primary Specialty :	Hematology/oncology
Medical School :	Nova Southeastern College Of Osteo Medicine
Graduation Year :	2013
Accepts Medicare?	Yes. Dr. Derrick Lee Goubeaux accepts medicare insurance.

Group Practice Association:

Dr. Derrick Lee Goubeaux is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Derrick Lee Goubeaux is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
University Pediatric Associates, Inc.	2163326794	123	705 Riley Hospital Dr Indianapolis, IN - 462025109 Ph: 3179445000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Derrick Lee Goubeaux are as mentioned. Primary taxonomy code for Dr. Derrick Lee Goubeaux, D.O. is 2080P0207X (Pediatrics, Pediatric Hematology-Oncology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0207X	Pediatrics, Pediatric Hematology-Oncology	Yes	2080P0207X	IN

Other Practice Locations:

Practice Address	City, State	Phone Number
11104 PARKVIEW CIRCLE DR STE 50, FORT WAYNE, IN, 46845-1733 United States	FORT WAYNE, IN	260-266-5400

Endpoints:

Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 1026 Indianapolis, IN, 46206-1026 United States
Phone Number :	317-777-6435

Business Location:

Patients can refer following map for directions to Dr. Derrick Lee Goubeaux practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.