DEREK J METCALFE MD
NPI 1285211979
Ophthalmology in Lancaster, MA
NPI Status: Active since March 27, 2021
Contact Information
479 OLD UNION TPKE
LANCASTER, MA
ZIP 01523
Phone: (978) 537-3900
Fax: (978) 537-6030
- Individual
- Male
- Ophthalmology
- PECOS Enrolled
About DEREK METCALFE
This page provides the complete NPI Profile along with additional information for Derek Metcalfe, a provider established in Lancaster, Massachusetts with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1285211979 assigned on March 2021. The practitioner's primary taxonomy code is 207W00000X with license number 1021929 (MA). The provider is registered as an individual and his NPI record was last updated February 2025.
- NPI
- 1285211979
- Provider Name
- DEREK J METCALFE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 479 OLD UNION TPKE LANCASTER, MA 01523
- Location Phone
- (978) 537-3900
- Location Fax
- (978) 537-6030
- Mailing Address
- 479 OLD UNION TPKE LANCASTER, MA 01523
- Mailing Phone
- (978) 537-3900
- Mailing Fax
- (978) 537-6030
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-27-2021
- Last Update Date
- 02-20-2025
- Code Navigator
Ophthalmologists like Derek Metcalfe specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Location Map
Secondary Locations
- 281 Lincoln St
Worcester, MA 01605
(508) 334-1000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 1021929
- License State
- MA
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Derek Metcalfe is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 01523 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.47
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.61
- Minimum New Patient Copayment $14.71
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $73.22
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $18.3
- Minimum Established Patient Copayment $4.77
- Maximum Established Patient Copayment $36.21
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 8 | 5 | 2 | 1 | 1 | 9 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 16 | 5 | 4 | 1 | 2 | 9 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 6 + 5 + 4 + 1 + 2 + 9 + 1 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1285211979 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1154342624 | MICHAEL M FU O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1326069899 | JOHN MARABELLO O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1932120409 | RICHARD C ERICKSON O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1922020874 | D'AMBROSIO EYE CARE, INC. Organization | Ophthalmology | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1639481666 | DR. FARAH LAKHANI O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1720390248 | JANINE VECCHIARELLO O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1427338755 | SARA ANNE APOLLONIO O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1578714150 | DR. SURAJ SADEGHI AFSHAR O.D. Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1184008187 | DR. KUN NANCY WU OD Individual | Optometrist | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1477906832 | JOCELYN K MYLOTT Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 728-5440 |
| 1063965754 | STEVEN M BUFFONE Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1831642404 | JOAN SHANDROWSKI Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1023561693 | JESSICA JONES Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1851844526 | LORI GOMES Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1912450586 | SANDRA L STEELE Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1225581994 | ROMELIA ERICSON Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1932652609 | EDWARD JACKSON Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1376096941 | THOMAS A PIERCE Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1619420387 | SEAN M CALLINAN Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
| 1245783919 | HENRY K CHIU Individual | Technician/Technologist (Optician) | 479 OLD UNION TPKE LANCASTER, MA 01523 (978) 537-3900 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285211979, enumerated in the NPI registry as an "individual" on March 27, 2021
The provider is located at 479 Old Union Tpke Lancaster, Ma 01523 and the phone number is (978) 537-3900
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $134.47 with an average copayment of $33.61 for new patient appointments. Established patients should expect a typical charge of $73.22 and an average copayment of 18.3. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on March 27, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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