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DEREK J DAWSON M.D.
NPI 1013992411
Ophthalmology in Munster, IN

Active since December 08, 2005PECOS EnrolledAccepts Medicare Assignment
84.89/100
CMS Quality Rating
8256 HOHMAN AVE, MUNSTER, IN 46321(219) 836-2770(219) 836-0438 Get Directions Write a Review

NPPES record last updated: September 6, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Derek J Dawson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK J DAWSON M.D. (NPI 1013992411) is an individual ophthalmology provider in Munster, Indiana, licensed in Indiana (01033635A) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Advocate Trinity Hospital, and is a graduate of Meharry Medical College School Of Medicine (1980).

NPPES Registry Identity

NPI1013992411
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDEREK J DAWSONCredential: M.D.
Location Address8256 HOHMAN AVEMunster, IN 46321-1516
Mailing Address536 W 55th AveMerrillville, IN 46410-2010 · (219) 836-2770 · Fax (219) 836-0438
Phone(219) 836-2770
Fax(219) 836-0438
Sole ProprietorYes
Medical School CMSMeharry Medical College School Of MedicineGraduated 1980
Enumeration DateDecember 8, 2005
Last NPPES UpdateSeptember 6, 2011
✔ NPI 1013992411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in IN · 01033635A
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
8256 HOHMAN AVE, Munster, IN 46321
Open in Google Maps ↗

Other Identifiers 5

Medicare ID-Type Unspecified134350IN
Medicare ID-Type Unspecified563870IL
Medicaid100215670IN
Medicare UPINC25456
Medicare UPIN756470IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek J Dawson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981592649
PECOS Enrollment IDI20040305000516, I20120105000159
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Derek Dawson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Suburban Eye Specialists
17 mi
Ophthalmology
10436 SOUTHWEST HWY STE 101
Chicago Ridge, IL 60415
  • Reassigned Medicare billing, Illinois and Indiana enrollments
  • 17 clinicians in this Medicare group
NPI 1043794506 (708) 586-4922
Illinois College Of Optometry
20 mi
Optometrist
3241 S MICHIGAN AVENUE
Chicago, IL 60616
  • Reassigned Medicare billing, Illinois enrollment
  • 143 clinicians in this Medicare group
NPI 1285612390 (312) 225-6200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
134 services93 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
94 services62 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
59 services49 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
41 services41 patients
Laser repair to improve eye fluid flow 65855
Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.
25 services15 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
24 services24 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Trinity Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140048
Location2320 E 93rd StChicago, IL 60617 · Cook County
Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150125
Location901 Macarthur BlvdMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46321 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost45.21

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Dawson's NPI number?

The NPI number for Derek Dawson is 1013992411. It was assigned to this individual provider in the NPPES registry on December 8, 2005.

Where is Derek Dawson located?

Derek Dawson practices at 8256 Hohman Ave, Munster, IN 46321. The listed phone number is (219) 836-2770.

What is Derek Dawson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Derek Dawson enrolled in Medicare?

Yes. Derek Dawson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Derek Dawson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Dawson reassigns Medicare benefits to 2 organizations: Suburban Eye Specialists (Chicago Ridge, IL) and Illinois College Of Optometry (Chicago, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Derek Dawson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Dawson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and CareSource list Derek Dawson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Derek Dawson affiliated with any hospitals?

According to CMS data, Derek Dawson is affiliated with Advocate Trinity Hospital and Community Hospital.

When was this NPI record last updated?

The NPPES record for Derek Dawson was last updated on September 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.