Active NPI 1477531317 Individual Practitioner Female Practitioner

Dr. Marguerite Ellen Ball-Thomas , OD

Optometrist • Winter Park, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Marguerite Ball-Thomas, OD is a certified Optometrist practicing in Winter Park, FL. With approximately 37 years of clinical experience since graduating from Southern College Of Optometry in 1989, Dr. Ball-Thomas delivers high-quality medical care to the local community at 1935 STATE ROAD 436.

Dr. Ball-Thomas is affiliated with James A Podschun Od Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, imaging of retina, exam of visual field with extended testing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1935 State Road 436

Winter Park, FL 327922244

Telephone 4076710960

Fax 4076776696

Associated Practice Facility / Clinic

🏢 James A Podschun Od Pa Facility NPI 1942518097

Medicare Profile & Education

Medical School

Southern College Of Optometry

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Winter Park, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

37 Yrs +14.3 yrs vs City Avg

City Avg: 22.7 Yrs

State Avg: 22.7 Yrs

Regional Practice Density

22 Specialists

Practicing in Winter Park, FL (3724 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

21.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ball-Thomas (37 Years) 37 Yrs

Winter Park Specialty Average (22.7 Years) 22.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	390	193	$138.92	$128.92
92134 Imaging of retina	116	98	$45.00	$39.13
92083 Exam of visual field with extended testing	55	51	$85.00	$62.28
92133 Imaging of optic nerve	53	49	$45.00	$33.31
92020 Examination of cornea and iris using lens device and slit lamp	47	46	$50.00	$27.23
92284 Evaluation of eye adaptation to light and dark with interpretation and report	38	28	$70.00	$36.11
92285 Photography of content of eyes	35	32	$33.00	$22.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$180.00	$170.37
92250 Photography of the retina	25	25	$55.00	$36.86
76514 Ultrasound scan of cornea to determine thickness	16	16	$25.00	$10.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	222	152	$140.00	$126.72
99213 Established patient office or other outpatient visit, typically 15 minutes	116	65	$109.72	$89.40
92134 Imaging of retina	107	92	$45.00	$38.57
92083 Exam of visual field with extended testing	47	40	$84.15	$60.12
92133 Imaging of optic nerve	41	35	$44.76	$32.91
92020 Examination of cornea and iris using lens device and slit lamp	36	34	$49.31	$26.93
92284 Evaluation of eye adaptation to light and dark with interpretation and report	32	26	$70.00	$44.01
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$180.00	$166.21
66984 Removal of cataract with insertion of lens	22	18	$200.00	$106.46
92285 Photography of content of eyes	20	19	$33.00	$22.38
92250 Photography of the retina	13	13	$55.00	$36.42
83516 Analysis of substance using immunoassay technique	11	11	$20.00	$11.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	162	130	$140.00	$127.57
99213 Established patient office or other outpatient visit, typically 15 minutes	151	92	$110.00	$90.81
92250 Photography of the retina	75	69	$55.00	$36.53
92134 Imaging of retina	64	51	$45.00	$38.09
92083 Exam of visual field with extended testing	57	51	$85.00	$61.10
92133 Imaging of optic nerve	57	54	$45.00	$33.62
92020 Examination of cornea and iris using lens device and slit lamp	40	40	$50.00	$27.59
92284 Evaluation of eye adaptation to light and dark with interpretation and report	39	29	$70.00	$56.16
92014 Established patient complete exam of visual system	30	30	$130.00	$124.78
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$180.00	$168.83
76514 Ultrasound scan of cornea to determine thickness	13	13	$25.00	$10.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	199	103	$85.84	$82.29
92014 Established patient complete exam of visual system	119	117	$130.00	$125.95
92250 Photography of the retina	70	69	$62.00	$38.99
92083 Exam of visual field with extended testing	64	53	$73.52	$62.47
92133 Imaging of optic nerve	58	50	$45.00	$34.33
92284 Evaluation of eye adaptation to light and dark with interpretation and report	47	36	$70.00	$58.11
92020 Examination of cornea and iris using lens device and slit lamp	42	41	$40.36	$27.85
92134 Imaging of retina	41	31	$45.00	$38.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	35	32	$127.14	$124.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$173.60	$171.02
66984 Removal of cataract with insertion of lens	19	14	$200.00	$52.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	183	95	$77.00	$74.98
92014 Established patient complete exam of visual system	114	112	$130.00	$124.55
92250 Photography of the retina	76	73	$65.00	$44.04
92083 Exam of visual field with extended testing	59	49	$70.00	$61.49
92133 Imaging of optic nerve	57	48	$45.00	$34.51
92020 Examination of cornea and iris using lens device and slit lamp	55	49	$35.00	$27.40
92284 Evaluation of eye adaptation to light and dark with interpretation and report	36	29	$70.00	$58.19
92134 Imaging of retina	29	28	$45.00	$38.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	19	$114.00	$108.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$172.00	$166.25
76514 Ultrasound scan of cornea to determine thickness	16	16	$25.00	$11.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	206	111	$77.04	$74.33
92014 Established patient complete exam of visual system	145	140	$126.99	$124.36
92250 Photography of the retina	116	107	$74.71	$49.75
92083 Exam of visual field with extended testing	74	64	$75.41	$63.00
92133 Imaging of optic nerve	71	61	$58.45	$34.67
92020 Examination of cornea and iris using lens device and slit lamp	59	53	$48.76	$27.51
92134 Imaging of retina	44	44	$69.23	$40.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	35	$125.89	$108.93
92284 Evaluation of eye adaptation to light and dark with interpretation and report	35	27	$70.00	$60.34
76514 Ultrasound scan of cornea to determine thickness	34	34	$33.18	$12.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$172.34	$165.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	146	73	$78.08	$72.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	114	100	$129.37	$106.06
92014 Established patient complete exam of visual system	98	98	$128.27	$121.36
92134 Imaging of retina	77	68	$88.81	$40.31
92250 Photography of the retina	77	72	$85.03	$55.72
92004 New patient complete exam of visual system	55	55	$158.36	$148.38
92020 Examination of cornea and iris using lens device and slit lamp	51	40	$57.73	$26.48
92083 Exam of visual field with extended testing	47	40	$88.94	$62.63
92133 Imaging of optic nerve	45	39	$79.73	$35.83
76514 Ultrasound scan of cornea to determine thickness	34	33	$33.53	$14.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	26	$50.00	$43.35
92226 Examination of eye by ophthalmoscope with retinal drawing	23	14	$32.00	$24.65
66984 Removal of cataract with insertion of lens	18	14	$201.67	$109.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$174.33	$164.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	221	209	$129.36	$102.76
99213 Established patient office or other outpatient visit, typically 15 minutes	154	82	$77.69	$69.45
92134 Imaging of retina	130	116	$104.00	$37.67
92250 Photography of the retina	93	93	$87.00	$61.66
92083 Exam of visual field with extended testing	58	51	$100.00	$59.58
92020 Examination of cornea and iris using lens device and slit lamp	55	50	$48.00	$25.55
92226 Examination of eye by ophthalmoscope with retinal drawing	54	30	$32.00	$23.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$177.00	$158.25

Medical Specialties & State Licenses

CMS Verified: 2022-10-11

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License FL OPC0002336

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.

Optometrist - Corneal and Contact Management

NUCC Taxonomy Code: 152WC0802X

State License FL OPC0002336

The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.

Optometrist - Pediatrics

NUCC Taxonomy Code: 152WP0200X

State License FL OPC0002336

Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

084796800 (FL)

Commercial Insurance / Payer ID 201602

UNITED HEALTH CARE (FL)

Commercial Insurance / Payer ID Aetna Hmo

0625244 (FL)

Commercial Insurance / Payer ID Champus

A005 (FL)

Commercial Insurance / Payer ID Aetna Ppo

4401350 (FL)

Commercial Insurance / Payer ID Palmetto (Dmerc)

0912730001 (FL)

Hospital & Practice Group Affiliations

James A Podschun Od Pa

1935 State Rd, Winter Park, FL 327922244

Phone: 4076710960

Practice Associates & Co-Workers

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

1 Associated Practitioners

Dr. James Podschun , OD

Optometrist

NPI 1003804121

Doctor of Optometry

Career & Practice History Timeline

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

9 Historical Events

📍

Updated Practice Location October 11, 2022

Registered at 1935 STATE ROAD 436, WINTER PARK, FL 327922244 (Tel: 4076710960)

📍

Updated Business Mailing Address October 11, 2022

Registered at 1935 STATE ROAD 436, WINTER PARK, FL 327922244 (Tel: 4076710960)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2022

Optometrist (License #OPC0002336 in FL)

✅

NPI Profile Active May 26, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location May 26, 2010

Registered at 1928 HOWELL BRANCH RD, WINTER PARK, FL 327921013 (Tel: 4076715445)

📍

Updated Business Mailing Address May 26, 2010

Registered at 1928 HOWELL BRANCH RD, WINTER PARK, FL 327921013 (Tel: 4076715445)

👤

Provider Name / Credentials Updated May 26, 2010

Recorded as MARGUERITE BALL-THOMAS, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 26, 2010

Optometrist (License #OPC0002336 in FL)

🟢

Initial NPI Registration & Enumeration December 31, 2005

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: 1477531317

Entity Type:

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

Enumeration Date: December 31, 2005

Last Update: October 11, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1935 State Road 436

Winter Park, FL 327922244

Phone: 4076710960

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.