Active NPI 1568595791 Individual Practitioner Male Practitioner

Dr. James W Cummins , OD

Optometrist • Spring Valley, CA

Professional Overview & Biography Verified Profile Summary

Dr. James Cummins, OD is a registered healthcare professional specializing in Optometrist in Spring Valley, CA. Practice services are available at 9628 CAMPO RD under active NPI credentials.

Frequently performed procedures and clinical services include extended exam of the back part of the eye with optic nerve drawing, new patient complete exam of visual system, established patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

9628 Campo Rd
Ste C

Spring Valley, CA 919771233

Telephone 6196700350

Fax 6196705950

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Spring Valley, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 24.5 Yrs

State Avg: 21.9 Yrs

Regional Practice Density

4 Specialists

Practicing in Spring Valley, CA (8588 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

33.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92202 Extended exam of the back part of the eye with optic nerve drawing	44	43	$39.00	$16.99
92004 New patient complete exam of visual system	36	36	$242.00	$166.47
92014 Established patient complete exam of visual system	34	31	$208.00	$140.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92202 Extended exam of the back part of the eye with optic nerve drawing	194	183	$44.87	$17.20
92004 New patient complete exam of visual system	141	141	$175.00	$166.68
92014 Established patient complete exam of visual system	81	78	$146.85	$140.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$140.63	$136.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92202 Extended exam of the back part of the eye with optic nerve drawing	134	129	$44.63	$17.10
92004 New patient complete exam of visual system	87	87	$168.79	$163.85
92014 Established patient complete exam of visual system	56	56	$141.93	$137.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	13	$115.67	$114.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92225 Examination of eye by ophthalmoscope with retinal drawing	747	331	$30.04	$29.46
92004 New patient complete exam of visual system	199	199	$165.00	$161.56
92014 Established patient complete exam of visual system	160	160	$139.32	$135.97
92250 Photography of the retina	71	63	$70.63	$54.44
99213 Established patient office or other outpatient visit, typically 15 minutes	63	38	$85.48	$78.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	43	$116.04	$112.87
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	11	11	$155.00	$152.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92225 Examination of eye by ophthalmoscope with retinal drawing	673	292	$30.13	$27.23
92014 Established patient complete exam of visual system	177	177	$138.89	$127.25
92004 New patient complete exam of visual system	146	146	$164.63	$151.25
92250 Photography of the retina	97	88	$85.00	$58.15
99213 Established patient office or other outpatient visit, typically 15 minutes	91	52	$85.00	$72.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	38	$115.72	$106.69
92081 Exam of visual field with limited testing	27	26	$45.00	$33.06
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	13	$149.29	$138.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92225 Examination of eye by ophthalmoscope with retinal drawing	683	308	$30.13	$26.42
92014 Established patient complete exam of visual system	176	176	$135.28	$122.22
92004 New patient complete exam of visual system	163	163	$159.54	$146.26
99213 Established patient office or other outpatient visit, typically 15 minutes	147	74	$85.00	$71.00
92250 Photography of the retina	94	89	$85.00	$65.72
92081 Exam of visual field with limited testing	24	22	$45.83	$31.67
92133 Imaging of optic nerve	18	15	$50.00	$35.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$118.33	$104.72

Medical Specialties & State Licenses

CMS Verified: 2020-10-07

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License CA OPT 6016 TPA

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

SD0060161 (CA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. John Fleming , OD

Optometrist

NPI 1033192133

Doctor of Optometry

Dr. Matthew Geller , OD

Optometrist

NPI 1033558069

Doctor of Optometry

Genoveva Avalos-Mireles , MSW LCSW

Counselor - Mental Health

NPI 1356486054

MSWLCSW

Dr. Katarzyna Borowski , DDS

Dentist

NPI 1881805448

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Practice Location October 07, 2020

Registered at 9628 CAMPO RD, STE C, SPRING VALLEY, CA 919771233 (Tel: 6196700350)

✅

NPI Profile Active April 20, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location April 20, 2009

Registered at 10225 AUSTIN DR STE 206, SPRING VALLEY, CA 919781522 (Tel: 6196700300)

📍

Updated Business Mailing Address April 20, 2009

Registered at 10225 AUSTIN DR STE 206, SPRING VALLEY, CA 919781522 (Tel: 6196700300)

👤

Provider Name / Credentials Updated April 20, 2009

Recorded as JAMES CUMMINS, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 20, 2009

Optometrist (License #OPT 6016 TPA in CA)

🟢

Initial NPI Registration & Enumeration March 14, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568595791

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 14, 2007

Last Update: October 07, 2020

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

10225 Austin Dr Ste 206

Spring Valley, CA 919781522

Phone: 6196700300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.