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

Derek Kabasawa, PA-C

Individual provider Physician Assistant · NPI 1710611884

Derek Kabasawa, PA-C is a Physician Assistant in Oklahoma City, Oklahoma. Qualified in 2022, 4 years ago. Practices with Olive Branch Psychiatry, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

13821 Technology Dr Ste B
Oklahoma City, OK 73134-1046
Phone: (405) 451-3454
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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 4813 (OK)

Record details

NPI number1710611884
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 13, 2022
Last updated in NPPESOctober 10, 2022
Certification dateOctober 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Olive Branch Psychiatry — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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