WILLIAM J. MALLON M.D.
NPI 1114976479
Ophthalmology in Vero Beach, FL

Q: What is William Mallon's NPI number?

The NPI number for William Mallon is 1114976479. It was assigned to this individual provider in the NPPES registry on May 6, 2006.

Q: What is William Mallon's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for William Mallon was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 06, 2006PECOS EnrolledAccepts Medicare Assignment

71.77/100

CMS Quality Rating

3500 US HIGHWAY 1, VERO BEACH, FL 32960(772) 299-1404(772) 299-1455 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About William J. Mallon M.d. NPPES

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

WILLIAM J. MALLON M.D. (NPI 1114976479) is an individual ophthalmology provider in Vero Beach, Florida, licensed in Florida (ME78127) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fort Pierce, and is a graduate of Wayne State University School Of Medicine (1994).

NPPES Registry Identity

NPI1114976479

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameWILLIAM J. MALLONCredential: M.D.

Location Address3500 US HIGHWAY 1Vero Beach, FL 32960-4511

Mailing Address145 Riverway DrVero Beach, FL 32963-2634 · (772) 234-6618

Phone(772) 299-1404

Fax(772) 299-1455

Sole ProprietorYes

Medical School CMSWayne State University School Of MedicineGraduated 1994

Enumeration DateMay 6, 2006

Last NPPES UpdateSeptember 25, 2023

NPPES CertifiedSeptember 25, 2023

✔ NPI 1114976479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in FL · ME78127

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.

3500 US HIGHWAY 1, Vero Beach, FL 32960

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Secondary Practice Location 1

Location 11707 S 25th StFort Pierce, FL 34947-4709 · Phone (772) 410-2810

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) 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

William J. Mallon 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 ID6305746280

PECOS Enrollment IDI20101019000090

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 Reassignment

Medicare enrollment records show William Mallon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

William J. Mallon, MD

Same address

Ophthalmology

3500 US HIGHWAY 1
Vero Beach, FL 32960

Reassigned Medicare billing, Florida enrollment
12 clinicians in this Medicare group

NPI 1649353582 (772) 299-1404

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 23

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.

Injection, onabotulinumtoxina, 1 unit J0585

Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.

2,860 services14 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.

1,132 services1,090 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

863 services747 patients

Insertion of drug delivery implant into tear duct of eye 68841

This procedure involves placing a small implant into your tear duct. The implant slowly releases medication to your eye, helping manage conditions like dry eyes or glaucoma. It's a simple, quick procedure typically performed under local anesthesia.

673 services376 patients

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.

664 services374 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

489 services314 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

417 services386 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

386 services382 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

245 services179 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.

221 services202 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

202 services199 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).

197 services191 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

189 services189 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

153 services150 patients

Injection of chemical for paralysis of nerve muscles on side of face 64612

This procedure involves injecting a chemical into specific facial nerves, causing temporary muscle paralysis. It's used to treat conditions like facial spasms or wrinkles. The effects are usually temporary, requiring repeat treatments.

37 services12 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.

34 services22 patients

Exam of visual field with intermediate testing 92082

An exam of the visual field with intermediate testing is a procedure that checks your peripheral (side) vision. It helps to identify blind spots which could be a sign of eye diseases. This non-invasive test is painless and quick.

28 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

Removal of growth of cornea 65400

The removal of a corneal growth is a procedure to eliminate abnormal tissue from the cornea, the clear front surface of the eye. This can help improve vision and alleviate discomfort. The process is typically performed by an ophthalmologist under local anesthesia.

25 services16 patients

Release of scar tissue between lens and retina using a laser 67031

This procedure involves using a laser to break up scar tissue that has formed between the lens and retina in your eye. This can help improve your vision by allowing light to reach the retina more effectively. It's a safe and common treatment for certain eye conditions.

24 services15 patients

Photography of content of eyes 92285

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

19 services19 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

17 services15 patients

Biopsy of eyelid 67810

A biopsy of the eyelid is a procedure where a small piece of tissue is taken from your eyelid for examination. It helps identify any abnormal growth like a lump or cyst. It's done under local anesthesia, so you won't feel pain during the process.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32960 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

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

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.

71.77/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

91.03

Improvement Activities

Cost

17.88

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…

53%484 patients3/55-star benchmark: 100%

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…

78%484 patients3/55-star benchmark: 100%

Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance…

100%385 patients

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

98%173 patients4/55-star benchmark: 100%

Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…

68%22 patients3/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%8,676 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

92%1,092 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

88%1,370 patients4/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 99% · 1,553 patients

Patients tobacco: 97% · 1,530 patients

5%59 patients1/55-star benchmark: 98%

Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months

86%271 patients4/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

97%1,370 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

10%1,370 patients1/55-star benchmark: 77%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 2,886 patients

0%2,886 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

4 suppliers271 claims271 services$62.39 avg. paid by Medicare

Sphere, single vision, plano to plus or minus 4.00, per lens V2100

Other-Vision, Hearing, and Speech Services · category OC000N

2 suppliers243 claims387 services$32.32 avg. paid by Medicare

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2103

Other-Vision, Hearing, and Speech Services · category OC000N

3 suppliers135 claims171 services$27.83 avg. paid by Medicare

Sphere, bifocal, plano to plus or minus 4.00d, per lens V2200

Other-Vision, Hearing, and Speech Services · category OC000N

2 suppliers21 claims32 services$42.70 avg. paid by Medicare

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203

Other-Vision, Hearing, and Speech Services · category OC000N

2 suppliers15 claims20 services$40.25 avg. paid by Medicare

Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier35 claims49 services$54.39 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEREK HUNTER OHLSTEIN M.D.

Ophthalmology