CECILIA R SANCHEZ M.D.
NPI 1376616011
Ophthalmology - Retina Specialist in Austin, TX

Active since November 17, 2006PECOS EnrolledAccepts Medicare Assignment
92.81/100
CMS Quality Rating
5717 BALCONES DR, AUSTIN, TX 78731(512) 327-7000(512) 314-1662 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 23, 2021, Jun 2, 2020 and 2 more (5 updates tracked since 2016).

About Cecilia R Sanchez M.d. NPPES

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

CECILIA R SANCHEZ M.D. (NPI 1376616011) is an individual retina specialist in Austin, Texas, licensed in Texas (N6637) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1376616011
Entity TypeIndividualFemale
Primary Taxonomy207WX0107X
Provider Legal NameCECILIA R SANCHEZCredential: M.D.
Location Address5717 BALCONES DRAustin, TX 78731
Mailing Address5717 Balcones DrAustin, TX 78731-4203 · (512) 327-7000 · Fax (512) 314-1662
Fax(512) 314-1662
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateNovember 17, 2006
Last NPPES UpdateJanuary 3, 20245 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2024
NPI 1376616011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License Licensed in TX · N6637
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License N6637 (TX)
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

Cecilia R Sanchez M.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 ID4688869795
PECOS Enrollment IDI20101115001308
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 13

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
6,780 services31 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.
712 services291 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.
466 services307 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.
455 services101 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.
448 services59 patients
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.
308 services163 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
Ophthalmology
5717 BALCONES DR
AUSTIN, TX 78731
Optometrist
5717 BALCONES DR
AUSTIN, TX 78731
Ophthalmology
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 Cecilia Sanchez's NPI number?

The NPI number for Cecilia Sanchez is 1376616011. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Where is Cecilia Sanchez located?

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

What is Cecilia Sanchez's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Cecilia Sanchez enrolled in Medicare?

Yes. Cecilia Sanchez 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 Cecilia Sanchez 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 11 other insurers list Cecilia Sanchez 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 Cecilia Sanchez 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.