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DEREK N. CUNNINGHAM O.D.
NPI 1265407084
Optometrist in Austin, TX

Active since February 23, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
901 MOPAC EXPRESSWAY SOUTH, BUILDING 4 SUITE 350, AUSTIN, TX 78746(512) 347-0255(512) 347-0785 Get Directions Write a Review

NPPES record last updated: October 21, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Derek N. Cunningham O.d. NPPES

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

DEREK N. CUNNINGHAM O.D. (NPI 1265407084) is an individual optometrist in Austin, Texas, licensed in Texas (06300T) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Waterloo - School Of Optometry (2002).

NPPES Registry Identity

NPI1265407084
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDEREK N. CUNNINGHAMCredential: O.D.
Location Address901 MOPAC EXPRESSWAY SOUTH, BUILDING 4 SUITE 350Austin, TX 78746-5776
Mailing Address901 Mopac Expressway South, Building 4 Suite 350Austin, TX 78746-5776 · (512) 347-0255 · Fax (512) 347-0785
Phone(512) 347-0255
Fax(512) 347-0785
Sole ProprietorNo
Medical School CMSUniversity Of Waterloo - School Of OptometryGraduated 2002
Enumeration DateFebruary 23, 2006
Last NPPES UpdateOctober 21, 2014
✔ NPI 1265407084 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 TX · 06300T✔ Licensed in AL · R164TA776
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.
901 MOPAC EXPRESSWAY SOUTH, Austin, TX 78746
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Other Identifiers 2

Medicare ID-Type Unspecified8B6942TX
Medicaid166400501TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.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 N. Cunningham 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 ID9537142666
PECOS Enrollment IDI20040610000502
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 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 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.
365 services213 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.
230 services218 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.
60 services60 patients
Placement of amniotic membrane on eye surface for wound healing 65778
The placement of an amniotic membrane on the eye surface is a treatment to promote healing of eye wounds. It involves placing a thin, protective layer over the eye. This layer, derived from the amniotic membrane, helps reduce inflammation and scarring, while encouraging healing.
47 services27 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.
42 services42 patients
Closure of tear duct opening using plug 68761
Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.
39 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78746 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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

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.

DR. MARISOL NABILA GOMEZ O.D
Optometrist
901 MOPAC EXPRESSWAY SOUTH, BUILDING 4, SUITE 350
AUSTIN, TX 78746
Travis County (512) 347-0255
DELL LASER CONSULTANTS, P.A.
Ophthalmology
901 MOPAC EXPRESSWAY SOUTH, BUILDING 4, SUITE 350
AUSTIN, TX 78746
Travis County (512) 347-0255
ALPAR NEPHROLOGY SERVICES, MD, PA
Internal Medicine (Nephrology)
901 MOPAC EXPRESSWAY SOUTH, BUILDING 1, STE. 300
AUSTIN, TX 78746
Travis County (512) 735-3013

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 Cunningham's NPI number?

The NPI number for Derek Cunningham is 1265407084. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Where is Derek Cunningham located?

Derek Cunningham practices at 901 Mopac Expressway South Building 4 Suite 350, Austin, TX 78746. The listed phone number is (512) 347-0255.

What is Derek Cunningham's specialty?

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

Is Derek Cunningham enrolled in Medicare?

Yes. Derek Cunningham 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 Cunningham accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Derek Cunningham 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 Derek Cunningham was last updated on October 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.