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DEREK J METCALFE MD
NPI 1285211979
Ophthalmology in Lancaster, MA

Active since March 27, 2021PECOS EnrolledAccepts Medicare Assignment
479 OLD UNION TPKE, LANCASTER, MA 01523(978) 537-3900(978) 537-6030 Get Directions Write a Review

NPPES record last updated: February 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 20, 2025, Apr 26, 2021, Mar 27, 2021 (3 updates tracked since 2021).

About Derek J Metcalfe Md NPPES

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

DEREK J METCALFE MD (NPI 1285211979) is an individual ophthalmology provider in Lancaster, Massachusetts, licensed in Massachusetts (1021929) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Medical Center/university Campus, and maintains a secondary practice location in Worcester.

NPPES Registry Identity

NPI1285211979
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDEREK J METCALFECredential: MD
Location Address479 OLD UNION TPKELancaster, MA 01523-3029
Mailing Address479 Old Union TpkeLancaster, MA 01523-3029 · (978) 537-3900 · Fax (978) 537-6030
Phone(978) 537-3900
Fax(978) 537-6030
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 2021
Enumeration DateMarch 27, 2021
Last NPPES UpdateFebruary 20, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2025
✔ NPI 1285211979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MA · 1021929
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.
479 OLD UNION TPKE, Lancaster, MA 01523
Open in Google Maps ↗

Secondary Practice Location 1

Location 1281 Lincoln StWorcester, MA 01605-2138 · Phone (508) 334-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Providence Health Plan.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 J Metcalfe 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 ID7810391638
PECOS Enrollment IDI20250528002160
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.

Hospital Affiliations CMS Care Compare

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

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01523 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
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 20

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

JESSICA JONES
Technician/Technologist (Optician)
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
STEVEN M BUFFONE
Technician/Technologist (Optician)
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
ELITE BOR-SHAVIT MD
Ophthalmology (Retina Specialist)
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
JUDY BAVONGKHOUN OD
Optometrist
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
MERITZA RONDON KLUGE O.D.
Optometrist
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
MICHAEL M FU O.D.
Optometrist
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900
DR. ANNA KRAWIEC OD
Optometrist
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (800) 325-3937
DR. KUN NANCY WU OD
Optometrist
479 OLD UNION TPKE
LANCASTER, MA 01523
Worcester County (978) 537-3900

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 Metcalfe's NPI number?

The NPI number for Derek Metcalfe is 1285211979. It was assigned to this individual provider in the NPPES registry on March 27, 2021.

Where is Derek Metcalfe located?

Derek Metcalfe practices at 479 Old Union Tpke, Lancaster, MA 01523. The listed phone number is (978) 537-3900.

What is Derek Metcalfe's specialty?

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

Is Derek Metcalfe enrolled in Medicare?

Yes. Derek Metcalfe 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 Metcalfe accept?

Health plans from Anthem Blue Cross and Blue Shield and Providence Health Plan list Derek Metcalfe 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 Metcalfe affiliated with any hospitals?

According to CMS data, Derek Metcalfe is affiliated with Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Derek Metcalfe was last updated on February 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.