BRADLEY CALLISTER (OD) – Optometrist, NPI 1033639349

BRADLEY CALLISTER (OD) is a healthcare provider. based in San clemente, California. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 33717TLG (CA). The NPI Number for BRADLEY CALLISTER (OD) is 1033639349

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY CALLISTER (OD)
NPI
1033639349
Phone
(949) 492-1853
Address
140 AVENIDA DEL MAR
Enumeration Date
27 June 2017
Last Update Date
11 February 2019

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
5624312031
Graduation Year
2017 (9 years ago)
PAC ID
2860767068
Group Practice PAC ID
9234472242
Professional Enrollment ID
I20171012003567
Address ID
CA907406247SE1190XHWYX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

3,909 OPTOMETRY in CA

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Provider Addresses for BRADLEY CALLISTER (OD)

  • 140, Avenida del Mar, San Clemente, Orange County, California, 92672, United States

    SAN CLEMENTE, CA 926724016

    Phone: (949) 492-1853

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 18 Open Payments records for all available years, with a total value of $481.

Total Amount is formed as General ($481) + Research ($0) + Ownership ($0) = $481.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: CooperVision Inc. ($438).

Total Amount

$481

General + Research + Ownership

Payments

18

Total payment records

General Amount

$481

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

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: 2017-10-12

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
I20171012003567IOptometryCATBD

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
92014Established patient complete exam of visual system102102$0
92250Photography of the retina102102$0
99213Established patient office or other outpatient visit, 20-29 minutes5245$0
92004New patient complete exam of visual system2727$0
99214Established patient office or other outpatient visit, 30-39 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 92672)

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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: 9234472242View full group profile
NameSpecialtyState
O P T O M E T R YCA
-CA
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
-CA
O P T O M E T R YMA
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 BRADLEY CALLISTER (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRADLEY CALLISTER (OD) uses 1033639349.
Is BRADLEY CALLISTER (OD) listed as active for patients and plans?
The listing shows BRADLEY CALLISTER (OD) as active in the NPI system.
What healthcare role does BRADLEY CALLISTER (OD) hold?
Scheduling teams often label BRADLEY CALLISTER (OD) under Optometrist. Clinical services aligned with this taxonomy classification.
Where should I expect BRADLEY CALLISTER (OD) on a map?
Expect San Clemente, California as a primary anchor for BRADLEY CALLISTER (OD) unless the record lists multiple sites.
Is the information about BRADLEY CALLISTER (OD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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