DR. KEVIN CLAYTON DIETRICH (M.D.) – Ophthalmology Physician, NPI 1639597636
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
396 OPHTHALMOLOGY in CO
Provider Addresses for DR. KEVIN CLAYTON DIETRICH (M.D.)
4423 STRATFORDSHIRE CT
TALLAHASSEE, FL 323092249
Phone: (850) 559-4093
Type: Mailing
13001 E. 17TH PLACE
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME
AURORA, CO 800452581
Phone: (303) 724-2685
Type: Location
2746 OLD US 20 WEST
SUITE B
ELKART, IN 465141365
Phone: (574) 293-3545
Fax: (574) 522-0599
Type: Mailing
1107 AIRPORT RD
BLOOMINGTON, IL 617042544
Phone: (309) 662-7700
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 61 Open Payments records for all available years, with a total value of $1,398.
Total Amount is formed as General ($1,398) + Research ($0) + Ownership ($0) = $1,398.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Alcon Vision LLC ($253).
Total Amount
$1,398
General + Research + Ownership
Payments
61
Total payment records
General Amount
$1,398
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $253 |
| Bausch & Lomb Americas Inc. | $228 |
| Mallinckrodt Hospital Products Inc. | $194 |
| ABBVIE INC. | $124 |
| Novartis Pharmaceuticals Corporation | $98 |
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: 2025-03-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20220415000812 | I | Ophthalmology | IL | TBD |
| I20250303000538 | I | Ophthalmology | IN | 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 |
|---|---|---|---|---|
| 92134 | Imaging of retina | 339 | 160 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 251 | 159 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 184 | 174 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 170 | 170 | $0 |
| 67028 | Injection of drug into eye | 133 | 36 | $0 |
Insurance plans in this area (ZIP 32309)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IN | |
| O P H T H A L M O L O G Y | IN | |
| O P T O M E T R Y | IN | |
| O P H T H A L M O L O G Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P H T H A L M O L O G Y | IN | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| O P T O M E T R Y | IN |
Reviews
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