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STEPHEN C. PFLUGFELDER M.D.
NPI 1851380216
Ophthalmology in Houston, TX

Active since October 18, 2005PECOS EnrolledAccepts Medicare Assignment
84.05/100
CMS Quality Rating
6550 FANNIN ST, SUITE 1501, HOUSTON, TX 77030(713) 798-6100(713) 798-4231 Get Directions Write a Review

NPPES record last updated: November 27, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Stephen C. Pflugfelder M.d. NPPES

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

STEPHEN C. PFLUGFELDER M.D. (NPI 1851380216) is an individual ophthalmology provider in Houston, Texas, licensed in Texas (L2770) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Chi St Luke's Health Baylor College Of Medicine Me, and is a graduate of State University Of New York - State College Optometry (1981).

NPPES Registry Identity

NPI1851380216
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSTEPHEN C. PFLUGFELDERCredential: M.D.
Location Address6550 FANNIN ST, SUITE 1501Houston, TX 77030-2717
Mailing AddressPo Box 4771Houston, TX 77210-4771 · (713) 798-6100 · Fax (713) 798-4231
Phone(713) 798-6100
Fax(713) 798-4231
Sole ProprietorNo
Medical School CMSState University Of New York - State College OptometryGraduated 1981
Enumeration DateOctober 18, 2005
Last NPPES UpdateNovember 27, 2020
NPPES CertifiedNovember 27, 2020
✔ NPI 1851380216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in TX · L2770
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.
6550 FANNIN ST, Houston, TX 77030
Open in Google Maps ↗

Other Identifiers 4

Other86276STX · Bc/bs
Medicaid045474601TX
Medicaid045474602TX
Other3164000TX · Blue Link

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice, Molina Healthcare 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

Stephen C. Pflugfelder 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 ID7416141312
PECOS Enrollment IDI20101104001085
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 10

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 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.
329 services147 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.
225 services220 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
40 services22 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
33 services23 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
30 services30 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.
29 services29 patients

Hospital Affiliations CMS Care Compare 2

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

Chi St Luke's Health Baylor College Of Medicine Me

Acute Care Hospitals · Houston, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450193
Location6720 Bertner Ave, Ste Mc1-266Houston, TX 77030 · Harris County
Emergency services

Harris Health System

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450289
Location2525 Holly HallHouston, TX 77054 · Harris County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
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.

84.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.49
Improvement Activities40
Cost54.39

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.

MEGAN MCCLANAHAN
Student in an Organized Health Care Education/Training Program
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 441-5155
MARIANNE CARLSON PSYD
Psychologist (Clinical)
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (346) 248-2040
MARIE MCLAIN P.A.
Physician Assistant
6550 FANNIN ST, SMITH TOWER, SUITE 1901
HOUSTON, TX 77030
Harris County (713) 441-1100
DALIA MOGHAZY MD
Obstetrics & Gynecology
6550 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 790-3311
YVONNE I-FANG CHU M.D.
Ophthalmology
6550 FANNIN ST, SUITE 1501
HOUSTON, TX 77030
Harris County (713) 798-6100
DR. SAM JERRY LONG D.D.S.
Dentist (General Practice)
6550 FANNIN ST, STE 2103
HOUSTON, TX 77030
Harris County (713) 797-0846
THOMAS W KNIGHT MD
Internal Medicine
6550 FANNIN ST, SMITH 1101
HOUSTON, TX 77030
Harris County (713) 441-0006
DR. JOOHI JIMENEZ-SHAHED M.D.
Psychiatry & Neurology (Neurology)
6550 FANNIN ST, SUITE 1801
HOUSTON, TX 77030
Harris County (713) 798-5975

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 Stephen Pflugfelder's NPI number?

The NPI number for Stephen Pflugfelder is 1851380216. It was assigned to this individual provider in the NPPES registry on October 18, 2005.

Where is Stephen Pflugfelder located?

Stephen Pflugfelder practices at 6550 Fannin St Suite 1501, Houston, TX 77030. The listed phone number is (713) 798-6100.

What is Stephen Pflugfelder's specialty?

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

Is Stephen Pflugfelder enrolled in Medicare?

Yes. Stephen Pflugfelder 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 Stephen Pflugfelder accept?

Health plans from Blue Cross and Blue Shield of Texas, Community Health Choice, Molina Healthcare, UnitedHealthcare and WellPoint list Stephen Pflugfelder 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 Stephen Pflugfelder affiliated with any hospitals?

According to CMS data, Stephen Pflugfelder is affiliated with Chi St Luke's Health Baylor College Of Medicine Me and Harris Health System.

When was this NPI record last updated?

The NPPES record for Stephen Pflugfelder was last updated on November 27, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.