STEVEN JOHN BOEYINK (OD) – Optometrist, NPI 1114061975

STEVEN JOHN BOEYINK (OD) is a healthcare provider. based in Carrollton, Georgia. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT001547 (GA). The NPI Number for STEVEN JOHN BOEYINK (OD) is 1114061975

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
STEVEN JOHN BOEYINK (OD)
NPI
1114061975
Phone
(770) 830-0072
Address
1109 S PARK STREET
Enumeration Date
16 February 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
7702540200
Graduation Year
1996 (30 years ago)
PAC ID
5193703684
Group Practice PAC ID
4183046733
Professional Enrollment ID
I20160815000745
Address ID
GA302631948NE47XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

959 OPTOMETRY in GA

Provider Addresses for STEVEN JOHN BOEYINK (OD)

  • 1109 S PARK STREET

    CARROLLTON, GA 30117

    Phone: (770) 830-0072

    Fax: (770) 214-1423

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-08-15

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
I20160815000745IOptometryGATBD

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

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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 30117)

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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: 4183046733View full group profile
NameSpecialtyState
O P T O M E T R YGA
O P T O M E T R YGA

Reviews

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Frequently asked questions

Can I cross-check STEVEN JOHN BOEYINK (OD) using NPI 1114061975?
NPI 1114061975 belongs to STEVEN JOHN BOEYINK (OD); compare other details if you need extra assurance.
Is there an active status for STEVEN JOHN BOEYINK (OD)?
For scheduling context, STEVEN JOHN BOEYINK (OD) is shown as active in the registry.
What kind of doctor is STEVEN JOHN BOEYINK (OD)?
STEVEN JOHN BOEYINK (OD) is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
Where in Georgia is STEVEN JOHN BOEYINK (OD) registered?
Use Carrollton, Georgia as the headline location for STEVEN JOHN BOEYINK (OD) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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