DR. GRACE J KIM (OD) – Optometrist, NPI 1760648497
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
851 OPTOMETRY in CO
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Provider Addresses for DR. GRACE J KIM (OD)
Walmart Supercenter, 2285, East Ken Pratt Boulevard, Longmont, Boulder County, Colorado, 80504, United States
LONGMONT, CO 805045223
Phone: (720) 652-0455
Fax: (303) 532-3269
Type: Mailing
333 RODDEN DR
ERIE, CO 805169104
Phone: (848) 219-3891
Type: Mailing
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.
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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: 2017-10-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171009001597 | I | Optometry | CO | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 30 | 30 | $0 |
| 92004 | New patient complete exam of visual system | 27 | 27 | $0 |
| 92012 | Established patient problem focused exam of visual system | 15 | 12 | $0 |
| 92250 | Photography of the retina | 12 | 11 | $0 |
Insurance plans in this area (ZIP 80504)
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