Derrick Wansom, MD is a medicare enrolled "Anesthesiology - Pain Medicine" physician in San Marcos, Texas. He went to Wayne State University School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as Pain Management. He is a member of the group practice Lone Star Spine And Pain Institute Llc and his current practice location is
1320 Wonder World Dr Ste 106, San Marcos, Texas. You can reach out to his office (for appointments etc.) via phone at
(512) 851-1165.
Derrick Wansom is licensed to practice in Texas (license number Q9077) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306124912.
Physician's Profile
Full Name | Derrick Wansom |
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Gender | Male |
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Speciality | Pain Management |
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Experience | 13 Years |
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Location | 1320 Wonder World Dr Ste 106, San Marcos, Texas |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Derrick Wansom attended and graduated from Wayne State University School Of Medicine in 2011
NPI Data:
- NPI Number: 1306124912
- Provider Enumeration Date: 07/31/2011
- Last Update Date: 11/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 1153625470
- Enrollment ID: I20160810000199
Medical Identifiers
Medical identifiers for Derrick Wansom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306124912 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207LP2900X | Anesthesiology - Pain Medicine | Q9077 (Texas) | Primary |
208VP0014X | Pain Medicine - Interventional Pain Medicine | Q9077 (Texas) | Secondary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Lone Star Spine And Pain Institute Llc | 4486032349 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Derrick Wansom allows following entities to bill medicare on his behalf.
Entity Name | Lone Star Spine And Pain Institute Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1851036347 PECOS PAC ID: 4486032349 Enrollment ID: O20220606000218 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derrick Wansom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Derrick Wansom, MD 1320 Wonder World Dr Ste 106, San Marcos, TX 78666-7558 Ph: (512) 851-1165 | Derrick Wansom, MD 1320 Wonder World Dr Ste 106, San Marcos, TX 78666-7558 Ph: (512) 851-1165 |
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