DEREK PI (OD) – Optometrist, NPI 1215517396

DEREK PI (OD) is a healthcare provider. based in Diamond bar, California. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 35155 (CA). The NPI Number for DEREK PI (OD) is 1215517396

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DEREK PI (OD)
NPI
1215517396
Phone
(909) 358-7491
Address
20612 SHEPHERD HILLS DR
Enumeration Date
12 April 2021
Last Update Date
9 August 2022

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
9093939058
Graduation Year
2022 (4 years ago)
PAC ID
9739563743
Group Practice PAC ID
9830448745
Professional Enrollment ID
I20220824003465
Address ID
CA917095825CH4200XPKWY401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,909 OPTOMETRY in CA

Provider Addresses for DEREK PI (OD)

  • 20612 SHEPHERD HILLS DR

    DIAMOND BAR, CA 917895402

    Phone: (909) 358-7491

    Type: Mailing

  • 4200 CHINO HILLS PKWY

    CHINO HILLS, CA 917093776

    Phone: (909) 393-9058

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $246.

Total Amount is formed as General ($246) + Research ($0) + Ownership ($0) = $246.

Last reported payment date: 2024-09-18 • Largest payer in this snapshot: Alcon Vision LLC ($147).

Total Amount

$246

General + Research + Ownership

Payments

4

Total payment records

General Amount

$246

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-08-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220824003465IOptometryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91789)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830448745View full group profile
NameSpecialtyState
O P T O M E T R YCA
O P T O M E T R YCA

Reviews

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Frequently asked questions

Does DEREK PI (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DEREK PI (OD) uses 1215517396.
Does CMS list DEREK PI (OD) as active?
Yes — DEREK PI (OD) is active in the NPI listing used on this page.
What healthcare role does DEREK PI (OD) hold?
Scheduling teams often label DEREK PI (OD) under Optometrist. Clinical services aligned with this taxonomy classification.
Where is DEREK PI (OD) based?
DEREK PI (OD) is tied to Diamond Bar, California in the data we show; additional addresses may exist on the full record.
Why does DEREK PI (OD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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