SCOTT KENNETH THEODORE – Optometrist, NPI 1669176731

SCOTT KENNETH THEODORE is a healthcare provider. based in Aurora, Colorado. specializing in OPTOMETRY. They hold a License No. 0618003264 (VA). The NPI Number for SCOTT KENNETH THEODORE is 1669176731

Main info

Male
3 Years Of Experience
Name
SCOTT KENNETH THEODORE
NPI
1669176731
Phone
(562) 533-8697
Address
1363 N Victor St # N120
Enumeration Date
30 March 2023
Last Update Date
12 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3075766655
Graduation Year
2023 (3 years ago)
PAC ID
5890143242
Group Practice PAC ID
2668451055
Professional Enrollment ID
I20231127001263
Address ID
CO802395152DE4804XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

851 OPTOMETRY in CO

Provider Addresses for SCOTT KENNETH THEODORE

  • 1363 N Victor St # N120

    Aurora, CO 800117082

    Phone: (562) 533-8697

    Type: Location

  • 4804 CHAMBERS RD

    DENVER, CO 802395152

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $145.

Total Amount is formed as General ($145) + Research ($0) + Ownership ($0) = $145.

Last reported payment date: 2024-09-20 • Largest payer in this snapshot: CooperVision Inc. ($105).

Total Amount

$145

General + Research + Ownership

Payments

3

Total payment records

General Amount

$145

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-20

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: 2023-11-27

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
I20231127001263IOptometryCOTBD

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
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes4444$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes3333$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes2020$0
92004New patient complete exam of visual system1313$0
View full utilization report →

Insurance plans in this area (ZIP 80011)

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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: 2668451055View full group profile
NameSpecialtyState
O P T O M E T R YCO
O P T O M E T R YNJ
O P T O M E T R YCO
O P T O M E T R YFL
O P T O M E T R YTX
-CO
O P T O M E T R YMI
O P T O M E T R YCO
O P T O M E T R YVA
O P T O M E T R YIL

Reviews

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Frequently asked questions

How do I look up SCOTT KENNETH THEODORE by NPI?
Use NPI 1669176731 when you need to reference SCOTT KENNETH THEODORE in forms, claims, or directories.
Is SCOTT KENNETH THEODORE currently active in the NPI registry?
CMS-published data lists SCOTT KENNETH THEODORE as an active registrant.
Does SCOTT KENNETH THEODORE list a primary specialty?
If you are matching referrals, note Optometrist for SCOTT KENNETH THEODORE. Clinical services aligned with this taxonomy classification.
What location shows for SCOTT KENNETH THEODORE?
We surface Aurora, Colorado for SCOTT KENNETH THEODORE based on available NPPES addresses.
How can I contact SCOTT KENNETH THEODORE?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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