SHUNDALE THOMAS MIXON (OD) – Optometrist, NPI 1013403088
Optometrist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
959 OPTOMETRY in GA
Provider Addresses for SHUNDALE THOMAS MIXON (OD)
2900 Peachtree Rd NW Ste 301
Atlanta, GA 303052193
Phone: (636) 200-4393
Type: Location
8400 Holcomb Bridge Rd Ste 440
Alpharetta, GA 300221837
Phone: (636) 200-4393
Type: Location
1300 PEACHTREE INDUSTRIAL BLVD STE 1206
SUWANEE, GA 300244550
Phone: (770) 783-2162
Fax: (770) 783-2165
Type: Mailing
8400 HOLCOMB BRIDGE RD STE 440
ALPHARETTA, GA 300221837
Phone: (636) 200-4393
Type: Location
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 753207173
Phone: (636) 200-4393
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $1,787.
Total Amount is formed as General ($1,787) + Research ($0) + Ownership ($0) = $1,787.
Last reported payment date: 2024-05-14 • Largest payer in this snapshot: CooperVision Inc. ($967).
Total Amount
$1,787
General + Research + Ownership
Payments
20
Total payment records
General Amount
$1,787
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $967 |
| Optos, Inc. | $302 |
| Glaukos Corporation | $147 |
| Sun Pharmaceutical Industries Inc. | $106 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $105 |
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: 2019-05-20
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 |
|---|---|---|---|---|
| I20190520001460 | I | Optometry | GA | 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 30305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA |
Reviews
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