Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Berta

Individual provider Physician Assistant · NPI 1114572716

Derek Berta is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2019, 7 years ago. Practices with MUSC Community Physicians, a 1,339-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
7
Licensed in
ID
In the registry since
2019
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Practice location Address checks out

2860 Channing Way Ste 220
Idaho Falls, ID 83404-7541
Phone: (208) 800-6155
Fax: (208) 800-6158
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3371894 (ID)

Record details

NPI number1114572716
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 9, 2019
Last updated in NPPESMarch 17, 2026
Certification dateMarch 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Musc Community Physicians — 1339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Idaho Falls