PRATIMA GAUTAM (OD) – Optometrist, NPI 1114658267
Optometrist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
3,935 OPTOMETRY in CA
Provider Addresses for PRATIMA GAUTAM (OD)
1300 N Vermont Ave Ste 101
Los Angeles, CA 900276098
Phone: (323) 906-6048
Fax: (323) 644-4442
Type: Location
220 WHEELER ST
CLIFFSIDE PARK, NJ 070101114
Phone: (201) 245-0700
Type: Mailing
940 BELMONT ST
BROCKTON, MA 023015596
Phone: (508) 583-4500
Type: Location
1040 FLYNN RD
CAMARILLO, CA 930125092
Phone: (805) 673-3930
Fax: (805) 659-3217
Type: Mailing
801 COOPER RD
OXNARD, CA 930305445
Phone: (805) 330-8100
Fax: (805) 240-7383
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $382.
Total Amount is formed as General ($382) + Research ($0) + Ownership ($0) = $382.
Last reported payment date: 2023-11-17 • Largest payer in this snapshot: Alcon Vision LLC ($258).
Total Amount
$382
General + Research + Ownership
Payments
8
Total payment records
General Amount
$382
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $258 |
| Bausch & Lomb Americas Inc. | $124 |
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: 2023-07-20
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20230720002024 | I | Optometry | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90027)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| Family Practice, Emergency Medicine | CA | |
| O P T O M E T R Y | CA | |
| O P T O M E T R Y | CA | |
| - | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| - | CA |
Reviews
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