1. Home
  2. Directory
  3. Washington
  4. Vancouver
  5. Optometrist
  6. NPI Profile

KRISTEN ELAINE DERRY
NPI 1730523788
Optometrist in Vancouver, WA

Active since April 22, 2013PECOS EnrolledAccepts Medicare Assignment
12116 SE MILL PLAIN BLVD STE 1, VANCOUVER, WA 98684(360) 719-1512(503) 254-0576 Get Directions Write a Review

NPPES record last updated: October 3, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kristen Elaine Derry NPPES

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

KRISTEN ELAINE DERRY (NPI 1730523788) is an individual optometrist in Vancouver, Washington, licensed in Washington (60503088) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (2014).

NPPES Registry Identity

NPI1730523788
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKRISTEN ELAINE DERRY
Location Address12116 SE MILL PLAIN BLVD STE 1Vancouver, WA 98684-6000
Mailing Address5105 Sw Elm AveBeaverton, OR 97005-4230 · (541) 659-9318
Phone(360) 719-1512
Fax(503) 254-0576
Sole ProprietorYes
Medical School CMSPacific University - College Of OptometryGraduated 2014
Enumeration DateApril 22, 2013
Last NPPES UpdateOctober 3, 2022
NPPES CertifiedOctober 1, 2022
✔ NPI 1730523788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in WA · 60503088✔ Licensed in OR · 3579ATI
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
12116 SE MILL PLAIN BLVD STE 1, Vancouver, WA 98684
Open in Google Maps ↗

Other Identifiers 1

Medicaid500740584OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristen Elaine Derry 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 ID42524175
PECOS Enrollment IDI20231204002933
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.

Medicare Billing Reassignment

Medicare enrollment records show Kristen Derry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Derry Family Eyecare LLC
Same address
Optometrist
12116 SE MILL PLAIN BLVD, SUITE 1
Vancouver, WA 98684
  • Reassigned Medicare billing, Washington enrollment
NPI 1396459616 (360) 892-3828

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98684 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
$130.99 typical visit price
range $57.27 – $172.80
Typical copayment $32.74 (range $14.31 – $43.20)
Most-billed visit code 99204
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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

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

RICHARDSON EYE CLINIC, PLLC
Optometrist
12116 SE MILL PLAIN BLVD STE 1
VANCOUVER, WA 98684
Clark County (360) 892-3828

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 Kristen Derry's NPI number?

The NPI number for Kristen Derry is 1730523788. It was assigned to this individual provider in the NPPES registry on April 22, 2013.

Where is Kristen Derry located?

Kristen Derry practices at 12116 SE Mill Plain Blvd Ste 1, Vancouver, WA 98684. The listed phone number is (360) 719-1512.

What is Kristen Derry's specialty?

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

Is Kristen Derry enrolled in Medicare?

Yes. Kristen Derry 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.

Which organization bills Medicare for Kristen Derry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristen Derry reassigns Medicare benefits to Derry Family Eyecare LLC (Vancouver, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristen Derry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristen Derry accept?

Health plans from Ambetter Health, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 4 other insurers list Kristen Derry 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 Kristen Derry was last updated on October 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.