DR. MICHAEL J MAVENCAMP (OD) – Optometrist, NPI 1760541676

DR. MICHAEL J MAVENCAMP (OD) is a healthcare provider. based in Fairbanks, Alaska. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. A240 (AK). The NPI Number for DR. MICHAEL J MAVENCAMP (OD) is 1760541676

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL J MAVENCAMP (OD)
NPI
1760541676
Phone
(907) 479-4700
Address
570 RIVERSTONE WAY
Enumeration Date
6 December 2006
Last Update Date
28 August 2012

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
7618995242
Group Practice PAC ID
9436234994
Professional Enrollment ID
I20051102000893
Address ID
AK997093420Fa4169XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

146 OPTOMETRY in AK

Provider Addresses for DR. MICHAEL J MAVENCAMP (OD)

  • 570 RIVERSTONE WAY

    STE 3

    FAIRBANKS, AK 99709

    Phone: (907) 479-4700

    Fax: (907) 457-5596

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $486.

Total Amount is formed as General ($486) + Research ($0) + Ownership ($0) = $486.

Last reported payment date: 2024-07-10 • Largest payer in this snapshot: Horizon Therapeutics plc ($125).

Total Amount

$486

General + Research + Ownership

Payments

11

Total payment records

General Amount

$486

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-10

Latest reported date

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: 2005-11-02

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
I20051102000893IOptometryAKTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes219152$0
92250Photography of the retina129108$0
92083Exam of visual field with extended testing10479$0
92133Imaging of optic nerve9071$0
92014Established patient complete exam of visual system7878$0
View full utilization report →

Insurance plans in this area (ZIP 99709)

Loading plans...

Provider's Procedures

DR. MICHAEL J MAVENCAMP (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYAK92083Measurement of field of vision during daylight conditions5744
OPTOMETRYAK92134Diagnostic imaging of retina2116

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: 9436234994View full group profile
NameSpecialtyState
O P T O M E T R YAK
O P T O M E T R YAK
O P T O M E T R YAK

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.

Frequently asked questions

What is the registry number for DR. MICHAEL J MAVENCAMP (OD)?
The registry entry for DR. MICHAEL J MAVENCAMP (OD) shows NPI 1760541676.
Is DR. MICHAEL J MAVENCAMP (OD) currently accepting referrals based on NPI status?
Registry metadata lists DR. MICHAEL J MAVENCAMP (OD) as active.
What does the directory say DR. MICHAEL J MAVENCAMP (OD) does?
Insurance directories may phrase it differently, but here DR. MICHAEL J MAVENCAMP (OD) maps to Optometrist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. MICHAEL J MAVENCAMP (OD)?
DR. MICHAEL J MAVENCAMP (OD) is associated with Fairbanks, Alaska in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

Similar Providers

116, Minnie Street, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1164411930
116, Minnie Street, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1346228517
116, Minnie Street, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1881673853
PO BOX 71618
NPI: 1568478782

ANITA MULLINS

Optometrist
201 OLD STEESE HWY STE 2
NPI: 1114935616
1867 AIRPORT WAY STE 150A
NPI: 1154430866
750, Eastview Drive, Fairbanks North Star Borough, Alaska, 99712, United States
NPI: 1679678809
59, College Road, Slaterville, Fairbanks, Fairbanks North Star Borough, Alaska, 99701, United States
NPI: 1558453753

EYE CLINIC OF FAIRBANKS, INC

Ophthalmology Physician
116, Minnie Street, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
NPI: 1003980525