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DEREK T SPRUNGER MD
NPI 1184625311
Ophthalmology - Pediatric Ophthalmology and Strabismus Specialist in Carmel, IN

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
201 PENNSYLVANIA PKWY STE 100, CARMEL, IN 46280(317) 817-1333 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Derek T Sprunger Md NPPES

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

DEREK T SPRUNGER MD (NPI 1184625311) is an individual pediatric ophthalmology and strabismus specialist in Carmel, Indiana, licensed in Indiana (01035269) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health North Hospital, and is a graduate of Indiana University School Of Medicine (1985).

NPPES Registry Identity

NPI1184625311
Entity TypeIndividualMale
Primary Taxonomy207WX0110X
Provider Legal NameDEREK T SPRUNGERCredential: MD
Location Address201 PENNSYLVANIA PKWY STE 100Carmel, IN 46280-1393
Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959 · (317) 962-4792
Phone(317) 817-1333
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1985
Enumeration DateAugust 10, 2005
Last NPPES UpdateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
✔ NPI 1184625311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Pediatric Ophthalmology and Strabismus SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0110X
License✔ Licensed in IN · 01035269
Definition
An ophthalmologist who specializes in pediatric ophthalmology and strabismus management. The subspecialty includes the medical and surgical management of eye disorders found in children. Some of the more common disorders include amblyopia, strabismus, refractive error, cataract and glaucoma. These disorders may be related to neurological and endocrinological diseases, trauma, or aging changes in the extraocular muscles requiring medical, optical and surgical management.
Also ListedOphthalmologyTaxonomy 207W00000X · License 01035269 (IN)
201 PENNSYLVANIA PKWY STE 100, Carmel, IN 46280
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Other Identifiers 3

Medicaid100132290CIN
Other180016782IN · Railroad Medicare
Medicaid100132290IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek T Sprunger Md 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 ID8426032434
PECOS Enrollment IDI20040616001396
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.

Areas of Expertise CMS Part B claims 7

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.

Exam to measure eye deviation and range of motion 92060
This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.
80 services70 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
31 services26 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.
31 services31 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.
28 services28 patients
Realignment of horizontal eye muscle 67311
Realignment of horizontal eye muscle is a surgical procedure to correct strabismus, a condition where your eyes don't align properly. The surgeon adjusts the muscles that control eye movement, improving coordination and focus. This helps to restore normal eye alignment and functioning.
15 services13 patients
Realignment of eye muscle complicated by scarring or restrictive muscle movement 67332
This procedure adjusts the eye muscle to correct vision issues caused by scarring or limited muscle movement. It involves altering the position or length of the muscle to enable better eye alignment and movement, improving eye coordination and focus.
13 services12 patients

Hospital Affiliations CMS Care Compare

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

Indiana University Health North Hospital

Acute Care Hospitals · Carmel, IN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150161
Location11700 N Meridian StCarmel, IN 46032 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46280 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.

Other Providers at the Same Location NPPES 12

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

EILISH MARY ANDERSON ATC
Specialist/Technologist (Athletic Trainer)
201 PENNSYLVANIA PKWY STE 100
INDIANAPOLIS, IN 46280
Hamilton County (317) 817-1200
DENNIS S. KOVACH DPT
Physical Therapist
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 817-1200
BRYAN MICHAEL SALTZMAN MD
Orthopaedic Surgery
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 944-9400
ANDREW OWENS PA-C
Physician Assistant
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 274-4377
J ANDREW PARR MD
Orthopaedic Surgery
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 944-4400
CHRISTOPHER D COLLIER MD
Orthopaedic Surgery
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 944-9400
LINDSEY STIFFLER
Specialist/Technologist (Athletic Trainer)
201 PENNSYLVANIA PKWY STE 100
INDIANAPOLIS, IN 46280
Hamilton County (317) 817-1200
DEVIN JAMES CONWAY MD, MPH
Orthopaedic Surgery
201 PENNSYLVANIA PKWY STE 100
CARMEL, IN 46280
Hamilton County (317) 944-9400

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 Sprunger's NPI number?

The NPI number for Derek Sprunger is 1184625311. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Derek Sprunger located?

Derek Sprunger practices at 201 Pennsylvania Pkwy Ste 100, Carmel, IN 46280. The listed phone number is (317) 817-1333.

What is Derek Sprunger's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Pediatric Ophthalmology and Strabismus Specialist, with taxonomy code 207WX0110X.

Is Derek Sprunger enrolled in Medicare?

Yes. Derek Sprunger 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.

What insurance does Derek Sprunger accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Derek Sprunger 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 Sprunger affiliated with any hospitals?

According to CMS data, Derek Sprunger is affiliated with Indiana University Health North Hospital.

When was this NPI record last updated?

The NPPES record for Derek Sprunger was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.