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SOPHIE CAI MD
NPI 1275914699
Ophthalmology in Hixson, TN

Active since June 11, 2015PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1961 NORTHPOINT BLVD # 11, HIXSON, TN 37343(423) 756-1002 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2025, Jun 7, 2024, Aug 16, 2021 and 1 more (4 updates tracked since 2019).

About Sophie Cai Md NPPES

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

SOPHIE CAI MD (NPI 1275914699) is an individual ophthalmology provider in Hixson, Tennessee, licensed in Tennessee (70249) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Erlanger Medical Center, and is a graduate of Harvard Medical School (2015).

NPPES Registry Identity

NPI1275914699
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameSOPHIE CAICredential: MD
Location Address1961 NORTHPOINT BLVD # 11Hixson, TN 37343-4556
Mailing Address9050 Executive Park Dr Ste 202aKnoxville, TN 37923-4670 · (865) 338-5432
Phone(423) 756-1002
Sole ProprietorNo
Medical School CMSHarvard Medical SchoolGraduated 2015
Enumeration DateJune 11, 2015
Last NPPES UpdateNovember 4, 20254 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
✔ NPI 1275914699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in TN · 70249✔ Licensed in MD · D91503✔ Licensed in NC · 2019-00606
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License L-263967 (MA)
Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License 2019-00606 (NC)
1961 NORTHPOINT BLVD # 11, Hixson, TN 37343
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State 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

Sophie Cai 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 ID4486962685
PECOS Enrollment IDI20240502000066, I20240522000375
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 8

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.

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.
419 services230 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.
209 services142 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
206 services42 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
133 services66 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.
61 services61 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.
61 services42 patients

Hospital Affiliations CMS Care Compare

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

Erlanger Medical Center

Acute Care Hospitals · Chattanooga, TN
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440104
Location975 E 3rd StChattanooga, TN 37403 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37343 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

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 Sophie Cai's NPI number?

The NPI number for Sophie Cai is 1275914699. It was assigned to this individual provider in the NPPES registry on June 11, 2015.

Where is Sophie Cai located?

Sophie Cai practices at 1961 Northpoint Blvd # 11, Hixson, TN 37343. The listed phone number is (423) 756-1002.

What is Sophie Cai's specialty?

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

Is Sophie Cai enrolled in Medicare?

Yes. Sophie Cai 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 Sophie Cai accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 4 other insurers list Sophie Cai 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 Sophie Cai affiliated with any hospitals?

According to CMS data, Sophie Cai is affiliated with Erlanger Medical Center.

When was this NPI record last updated?

The NPPES record for Sophie Cai was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.