DEREK T SPRUNGER MD
NPI 1184625311
Ophthalmology - Pediatric Ophthalmology and Strabismus Specialist in Carmel, IN
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, and is a graduate of Indiana University School Of Medicine (1985).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Accepted 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 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.
Medicare Billing Reassignments
3Medicare enrollment records show Derek Sprunger reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 5,212 clinicians in this Medicare group
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 737 clinicians in this Medicare group
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 523 clinicians in this Medicare group
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 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Indiana University Health
Acute Care Hospitals · Indianapolis, INPhysician 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.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
INDIANAPOLIS, IN 46280
INDIANAPOLIS, IN 46280
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.
Which organizations bill Medicare for Derek Sprunger's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Derek Sprunger reassigns Medicare benefits to 3 organizations: Iu Health Medical Group, LLC (Indianapolis, IN), University Family Physicians, Inc. (Indianapolis, IN) and Iu Health Medical Group Riley Specialists, LLC (Indianapolis, IN). 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 Sprunger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Derek Sprunger accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer 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.
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.
# Derek T Sprunger, MD · NPI 1184625311
Pediatric Ophthalmology and Strabismus Specialist physician in Carmel, Indiana. Individual provider, active in the CMS NPPES registry since August 10, 2005.
## Identity
- **NPI:** 1184625311 (Entity type: Individual)
- **Enumerated:** August 10, 2005
- **Primary specialty:** Ophthalmology - Pediatric Ophthalmology and Strabismus Specialist · taxonomy 207WX0110X
- **State license:** 01035269 (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 201 PENNSYLVANIA PKWY STE 100, Carmel, IN 46280-1393
- **Phone:** (317) 817-1333
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Iu Health Medical Group, LLC (NPI 1326893777, Indianapolis, IN); University Family Physicians, Inc. (NPI 1043275787, Indianapolis, IN); Iu Health Medical Group Riley Specialists, LLC (NPI 1699561480, Indianapolis, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Indiana University School Of Medicine, class of 1985
## Record status
- **NPPES last updated:** November 17, 2020
- **Other identifiers:** Medicaid 100132290C (IN); Other 180016782 (IN); Medicaid 100132290 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1184625311) · Data from the CMS NPPES public registry.