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

Derek S Versalle, DO

Individual provider Emergency Medicine Physician · NPI 1669162616

Derek S Versalle, DO is an Emergency Medicine in Portage, Michigan. Graduated from Michigan State University College of Osteopathic Medicine in 2023, 3 years ago. Practices with Southwestern Michigan Emergency Services, PC, a 67-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
MI
In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

950 Trade Centre Way
Portage, MI 49002-0487
Phone: (269) 370-1824
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 5151016178 (MI)

Record details

NPI number1669162616
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 12, 2023
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026
Mailing address950 Trade Centre Way Ste 230, Portage, MI 49002-0492

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2023 (3 years in practice)
Group practice Southwestern Michigan Emergency Services, Pc — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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