Derek Mallory Mead, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6450TG Issued in TX

Practice address

1321 N Loop 1604 E Ste 100a
San Antonio, TX 78232-1438

Phone

(210) 545-7067

Fax

(210) 545-9629

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mead Eye Care PLLC

  • Optometrist
  • San Antonio, TX
  • NPI 1700208857
  Medicare reassignment NPD Authorized official
• Cynthia G. Phelps and Associates P.a.

  • Optometrist
  • San Antonio, TX
  • NPI 1396931507
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1043391782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N LOOP 1604 E STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321438",
            "telephone_number": "210-545-7067",
            "fax_number": "210-545-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N LOOP 1604 E STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321438",
            "telephone_number": "210-545-7067",
            "fax_number": "210-545-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD",
        "first_name": "DEREK",
        "middle_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6450TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MD Medco LLC
• MD Wellness PLLC
• MDCH Partners LLC
• Mdiaz Wound Care Consulting PLLC
• Mead Eye Care PLLC
• Joann Thomas Mead
• Teresa Lee Mead, PSYCHOLOGIST PHD
• Rachael Prine Meaders, CRNA
• Gregory Brant Meador, MD
• Meadow Lane Counseling PLLC

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.