DERRICK WANSOM (MD) – Pain Medicine (Anesthesiology) Physician, NPI 1306124912
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
755 PAIN MANAGEMENT in TX
Provider Addresses for DERRICK WANSOM (MD)
PO BOX 733946
DALLAS, TX 753733946
Phone: (512) 485-7200
Fax: (512) 485-7224
Type: Mailing
4100 DUVAL RD
BLDG 3 STE 200
AUSTIN, TX 787594275
Phone: (512) 485-7200
Fax: (512) 485-7224
Type: Location
1320 WONDER WORLD DR STE 106
SAN MARCOS, TX 786667558
Phone: (512) 851-1165
Fax: (833) 925-2433
Type: Location
2115 Stephens Pl Ste 1400
New Braunfels, TX 781302159
Phone: (830) 715-0538
Fax: (833) 925-2433
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $3,007.
Total Amount is formed as General ($3,007) + Research ($0) + Ownership ($0) = $3,007.
Last reported payment date: 2024-12-27 • Largest payer in this snapshot: Abbott Laboratories ($2,547).
Total Amount
$3,007
General + Research + Ownership
Payments
77
Total payment records
General Amount
$3,007
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $2,547 |
| Nalu Medical, Inc. | $123 |
| SI-BONE, INC. | $115 |
| Medtronic, Inc. | $52 |
| PAINTEQ LLC | $47 |
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: 2016-08-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160810000199 | I | Pain Management | TX | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 319 | 77 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 67 | 67 | $0 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 66 | 39 | $0 |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan tha | 45 | 25 | $0 |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 31 | 21 | $0 |
Insurance plans in this area (ZIP 75373)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | TX | |
| Pain Management, Anesthesiology, Interventional Pain Management | OH |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.