Dr. John C. Derickson , OD
Optometrist • Jacksonville, FL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Derickson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. John Derickson, OD was a registered Optometrist practicing in Jacksonville, FL. Throughout an active medical career spanning 1 years, Dr. Derickson provided care at the practice location at 8771 PERIMETER PARK CT until profile deactivation on 2006-03-22.
Historical Medicare Part B clinical services included photography of the retina, new patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.
Practice Location & Contact Primary Location
8771 Perimeter Park Ct
Suite 101
Jacksonville, FL 322166396
Specialty Benchmarks & Practice Insights
Comparative analytics for Optometrist in Jacksonville, FL
Practicing in Jacksonville, FL (3724 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Performed Procedures & Service Volume
Top Medicare Part B procedures performed by this practitioner
| HCPCS Code & Description | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
|
92250
Photography of the retina
|
14 | 14 | $60.00 | $51.29 |
|
92004
New patient complete exam of visual system
|
11 | 11 | $155.00 | $136.76 |
Medical Specialties & State Licenses
NUCC Taxonomy Code: 152W00000X
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.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Optometrist
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 04, 2021
Registered at 8771 PERIMETER PARK CT, SUITE 101, JACKSONVILLE, FL 322166396 (Tel: 9049978585)
Registered at 8771 PERIMETER PARK CT, SUITE 101, JACKSONVILLE, FL 322166396 (Tel: 9049978585)
Recorded as JOHN DERICKSON, O.D.
Optometrist (License #OPC3107 in FL)
Record officially reactivated for active practice on April 10, 2006
Record deactivated on March 22, 2006
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
8771 Perimeter Park Ct, Suite 101
Jacksonville, FL 322166396
Phone: 9049978585
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