ANGELINE DERHAM MD
NPI 1255795217
Ophthalmology in Austin, TX

Active since April 06, 2016PECOS EnrolledAccepts Medicare Assignment
92.81/100
CMS Quality Rating
5717 BALCONES DR, AUSTIN, TX 78731(512) 327-7000(512) 314-1661 Get Directions Write a Review

NPPES record last updated: January 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2024, Feb 3, 2023, Jul 15, 2022 and 5 more (8 updates tracked since 2020).

About Angeline Derham Md NPPES

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

ANGELINE DERHAM MD (NPI 1255795217) is an individual ophthalmology provider in Austin, Texas, licensed in Texas (S4460) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1255795217
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameANGELINE DERHAMCredential: MD
Location Address5717 BALCONES DRAustin, TX 78731-4203
Mailing Address5717 Balcones DrAustin, TX 78731-4203 · (512) 314-1613 · Fax (512) 314-1661
Fax(512) 314-1661
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 6, 2016
Last NPPES UpdateJanuary 3, 20248 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2024
NPI 1255795217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in TX · S4460
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.
5717 BALCONES DR, Austin, TX 78731

Accepted 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

Angeline Derham 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 ID2062757388
PECOS Enrollment IDI20200901001311
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 15

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 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.
217 services215 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.
198 services164 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.
84 services72 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).
78 services68 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.
57 services41 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.
52 services52 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78731 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
$131.95 typical visit price
range $57.88 – $174.00
Typical copayment $32.98 (range $14.47 – $43.50)
Most-billed visit code 99204
Established Patient
$71.95 typical visit price
range $18.88 – $142.23
Typical copayment $17.98 (range $4.72 – $35.55)
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.

92.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.68
Promoting Interoperability99
Improvement Activities40
Cost89.21

Other Providers at the Same Location NPPES 15

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

Eyewear Supplier
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology
5717 BALCONES DR
AUSTIN, TX 78731
Optometrist
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology (Retina Specialist)
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
5717 BALCONES DR
AUSTIN, TX 78731

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 Angeline Derham's NPI number?

The NPI number for Angeline Derham is 1255795217. It was assigned to this individual provider in the NPPES registry on April 6, 2016.

Where is Angeline Derham located?

Angeline Derham practices at 5717 Balcones Dr, Austin, TX 78731. The listed phone number is (512) 327-7000.

What is Angeline Derham's specialty?

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

Is Angeline Derham enrolled in Medicare?

Yes. Angeline Derham 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 Angeline Derham accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 12 other insurers list Angeline Derham 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 Angeline Derham was last updated on January 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.