BRETT WILLIAM FREDERICKSEN (OD) – Optometrist, NPI 1194392845
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
268 OPTOMETRY in ID
Provider Addresses for BRETT WILLIAM FREDERICKSEN (OD)
3485 N COLE RD UNIT 45479
BOISE, ID 837111095
Phone: (833) 776-2020
Fax: (208) 297-2518
Type: Mailing
291 N MILWAUKEE ST STE A-3
BOISE, ID 837049132
Phone: (833) 776-2020
Fax: (208) 297-5718
Type: Location
16448 N Midland Blvd
Nampa, ID 836875222
Phone: (833) 776-2020
Fax: (208) 297-7518
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $479.
Total Amount is formed as General ($479) + Research ($0) + Ownership ($0) = $479.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($272).
Total Amount
$479
General + Research + Ownership
Payments
17
Total payment records
General Amount
$479
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $272 |
| Johnson & Johnson Vision Care, Inc. | $63 |
| Astellas Pharma US Inc | $39 |
| ABBVIE INC. | $22 |
| CooperVision Inc. | $22 |
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: 2021-07-30
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 |
|---|---|---|---|---|
| I20210730001850 | I | Optometry | ID | 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 | 87 | 86 | $0 |
| 92004 | New patient complete exam of visual system | 52 | 52 | $0 |
| 92134 | Imaging of retina | 43 | 41 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 13 | $0 |
Insurance plans in this area (ZIP 83711)
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Group practice members
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| O P T O M E T R Y | TX | |
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