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

Derral Edward Hawthorne, PA-C

Individual provider Physician Assistant · NPI 1295169001

Derral Edward Hawthorne, PA-C is a Physician Assistant in Gold Beach, Oregon. Qualified in 2013, 13 years ago. Practices with North Bend Medical Center Inc, a 91-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
13
Licensed in
OR
In the registry since
2013
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

94180 2nd St
Gold Beach, OR 97444-8733
Phone: (541) 247-7047
Fax: (541) 247-0123
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA191287 (OR)

Record details

NPI number1295169001
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 28, 2013
Last updated in NPPESMarch 3, 2025
Certification dateMarch 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice North Bend Medical Center Inc — 91 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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