DR. MARILYN KAY HOLM (O.D.) – Optometrist, NPI 1104811488
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
146 OPTOMETRY in AK
Provider Addresses for DR. MARILYN KAY HOLM (O.D.)
PO BOX 287
CLAM GULCH, AK 995680287
Phone: (907) 252-2285
Fax: (866) 623-2285
Type: Mailing
55562 RAZOR CT
CLAM GULCH, AK 99568
Phone: (907) 252-2285
Fax: (866) 623-2285
Type: Location
240 W FRONT ST STE A
PORT ANGELES, WA 983622609
Phone: (360) 452-7891
Type: Mailing
2800 Cornerstone Dr Ste A6
Pagosa Springs, CO 811478157
Phone: (970) 731-4300
Type: Location
1026 E 1st St
Port Angeles, WA 983624020
Phone: (360) 452-7891
Fax: (360) 452-8087
Type: Location
933 E 1st St
Port Angeles, WA 983624012
Phone: (360) 452-7891
Fax: (360) 452-8087
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-08-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20130326000502 | I | Optometry | AK | TBD |
| I20231125000252 | I | Optometry | VI | TBD |
| I20250819005023 | I | Optometry | WA | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 36 | 24 | $0 |
| 92014 | Established patient complete exam of visual system | 31 | 31 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 20 | $0 |
| 92004 | New patient complete exam of visual system | 13 | 13 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 99568)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| - | WA | |
| Nurse Practitioner | WA | |
| Family Practice | WA | |
| Physician Assistant | WA | |
| Family Practice, Obstetrics/Gynecology | WA | |
| Family Practice | WA | |
| O P T O M E T R Y | WA | |
| Nurse Practitioner | WA | |
| Family Practice | WA |
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