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SAMUEL ADAM PHELPS O.D.
NPI 1164651998
Optometrist in Henderson, TN

Active since July 14, 2009PECOS EnrolledAccepts Medicare Assignment
95.76/100
CMS Quality Rating
138 S WASHINGTON AVE, HENDERSON, TN 38340(731) 989-3511 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 24, 2022, Oct 20, 2022, May 20, 2022 (3 updates tracked since 2022).

About Samuel Adam Phelps O.d. NPPES

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

SAMUEL ADAM PHELPS O.D. (NPI 1164651998) is an individual optometrist in Henderson, Tennessee, licensed in Tennessee (2957) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Southern College Of Optometry (2009).

NPPES Registry Identity

NPI1164651998
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameSAMUEL ADAM PHELPSCredential: O.D.
Location Address138 S WASHINGTON AVEHenderson, TN 38340-2323
Mailing Address668 Skyline DrJackson, TN 38301-3951 · (731) 424-2414
Phone(731) 989-3511
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 2009
Enumeration DateJuly 14, 2009
Last NPPES UpdateOctober 24, 20223 updates tracked since enumeration
NPPES CertifiedOctober 24, 2022
✔ NPI 1164651998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in TN · 2957✔ Licensed in VA · 0618001863
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
138 S WASHINGTON AVE, Henderson, TN 38340
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1668 Skyline DrJackson, TN 38301-3951 · Phone (731) 424-2414
Location 21340 Union University DrJackson, TN 38305-3780 · Phone (731) 424-2414

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana 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

Samuel Adam Phelps O.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 ID3476608449
PECOS Enrollment IDI20101109000481
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 Samuel Phelps reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Skyline Eye Clinic, PC
18 mi
Ophthalmology
668 SKYLINE DR
Jackson, TN 38301
  • Reassigned Medicare billing, Tennessee enrollment
  • 10 clinicians in this Medicare group
NPI 1154328813 (731) 424-2414

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.

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.
371 services292 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).
131 services103 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.
102 services99 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.
79 services70 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.
58 services55 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38340 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
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.

95.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.17
Promoting Interoperability100
Improvement Activities40
Cost87.7

Reported Quality Measures

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
100%224 patients5/55-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…
87%46 patients4/55-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.
98%1,315 patients4/55-star benchmark: 100%
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
100%115 patients5/55-star benchmark: 100%
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% · 696 patients
0%696 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

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
3 suppliers15 claims15 services$63.74 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 3

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

PHELPS EYE CARE, PLLC
Optometrist
138 S WASHINGTON AVE
HENDERSON, TN 38340
Chester County (731) 989-3511
DR. L. W. BLOOMINGBURG O.D.
Optometrist
138 S WASHINGTON AVE
HENDERSON, TN 38340
Chester County (731) 989-3511
LARRY-W-BLOOMINGBURG-OD
Eyewear Supplier
138 S WASHINGTON AVE
HENDERSON, TN 38340
Chester County (731) 989-3511

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 Samuel Phelps's NPI number?

The NPI number for Samuel Phelps is 1164651998. It was assigned to this individual provider in the NPPES registry on July 14, 2009.

Where is Samuel Phelps located?

Samuel Phelps practices at 138 S Washington Ave, Henderson, TN 38340. The listed phone number is (731) 989-3511.

What is Samuel Phelps's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Samuel Phelps enrolled in Medicare?

Yes. Samuel Phelps 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 organization bills Medicare for Samuel Phelps's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Phelps reassigns Medicare benefits to Skyline Eye Clinic, PC (Jackson, TN). The 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 Samuel Phelps's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Phelps accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 12 other insurers list Samuel Phelps 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.

When was this NPI record last updated?

The NPPES record for Samuel Phelps was last updated on October 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.