DARIN R. CUMMINGS O.D.
NPI 1306805007
Optometrist in Ephraim, UT

Active since March 21, 2006PECOS EnrolledAccepts Medicare Assignment
67.49/100
CMS Quality Rating
43 E 450 N, EPHRAIM, UT 84627(435) 283-5555(435) 283-8642 Get Directions Write a Review

NPPES record last updated: January 19, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Darin R. Cummings O.d. NPPES

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

DARIN R. CUMMINGS O.D. (NPI 1306805007) is an individual optometrist in Ephraim, Utah, licensed in Utah (2846438904) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Sanpete Valley Hospital - Cah, and is a graduate of Indiana University - School Of Optometry (2000).

NPPES Registry Identity

NPI1306805007
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDARIN R. CUMMINGSCredential: O.D.
Location Address43 E 450 NEphraim, UT 84627-4027
Mailing Address43 E 450 NEphraim, UT 84627-4027 · (435) 283-5555 · Fax (435) 283-8642
Fax(435) 283-8642
Sole ProprietorNo
Medical School CMSIndiana University - School Of OptometryGraduated 2000
Enumeration DateMarch 21, 2006
Last NPPES UpdateJanuary 19, 2012
NPI 1306805007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in UT · 2846438904
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.
43 E 450 N, Ephraim, UT 84627

Other Identifiers 9

Medicare NSC6040860001
Other328071UT · Altius Health Plans
Other639164Deseret Mutual Benefit Ad
Other59306UT · Pehp
Medicare PIN000061722UT
Medicare UPINU81469UT
Other02846439903001UT · Regence Bluecross/blue Sh
Other2004532United Healthcare
Other107008974104UT · Select Health

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

Darin R. Cummings 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 ID9739085143
PECOS Enrollment IDI20040107000979
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 11

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.
369 services356 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.
307 services245 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.
168 services137 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.
107 services70 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).
89 services77 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.
48 services48 patients

Hospital Affiliations CMS Care Compare 2

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

Sanpete Valley Hospital - Cah

Critical Access Hospitals · Mount Pleasant, UT
OwnershipVoluntary non-profit - Private
CMS Certification Number461303
Location1100 South Medical DriveMount Pleasant, UT 84647 · Sanpete County
Emergency services Birthing friendly

Gunnison Valley Hospital

Critical Access Hospitals · Gunnison, UT
OwnershipVoluntary non-profit - Other
CMS Certification Number461306
Location64 East 100 NorthGunnison, UT 84634 · Sanpete County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84627 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

67.49/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality84.53
Promoting Interoperability20
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
99%192 patients4/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
33%79 patients3/55-star benchmark: 91%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
90%29 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%1,698 patients5/55-star benchmark: 100%
e-Prescribing
87%164 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
0%766 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
31%1,683 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 82% · 437 patients
81%437 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
97%73 patients
Provide Patients Electronic Access to Their Health Information
1%664 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

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

Optometrist
43 E 450 N
EPHRAIM, UT 84627
Optometrist
43 E 450 N
EPHRAIM, UT 84627

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 Darin Cummings's NPI number?

The NPI number for Darin Cummings is 1306805007. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Darin Cummings located?

Darin Cummings practices at 43 E 450 N, Ephraim, UT 84627. The listed phone number is (435) 283-5555.

What is Darin Cummings's specialty?

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

Is Darin Cummings enrolled in Medicare?

Yes. Darin Cummings 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 Darin Cummings accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, BridgeSpan Health Company and Providence Health Plan and 3 other insurers list Darin Cummings 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 Darin Cummings affiliated with any hospitals?

According to CMS data, Darin Cummings is affiliated with Sanpete Valley Hospital - Cah and Gunnison Valley Hospital.

When was this NPI record last updated?

The NPPES record for Darin Cummings was last updated on January 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.