DR. GARY J LATTIMORE (OD) – Optometrist, NPI 1902863293

DR. GARY J LATTIMORE (OD) is a healthcare provider. based in Idaho falls, Idaho. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 0505 (ID). The NPI Number for DR. GARY J LATTIMORE (OD) is 1902863293

Main info

Male
Sole Proprietor
53 Years Of Experience
Accepts Medicare Assignment
Name
DR. GARY J LATTIMORE (OD)
NPI
1902863293
Phone
(208) 522-6271
Address
501 S WOODRUFF AVE
Enumeration Date
28 April 2006
Last Update Date
22 January 2010

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
2085226271
Graduation Year
1973 (53 years ago)
PAC ID
5193834455
Professional Enrollment ID
I20110620000470
Address ID
ID834015200ID501XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

268 OPTOMETRY in ID

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Provider Addresses for DR. GARY J LATTIMORE (OD)

  • South Woodruff Avenue, Idaho Falls, Bonneville County, Idaho, 83405, United States

    IDAHO FALLS, ID 834015200

    Phone: (208) 522-6271

    Fax: (208) 522-7217

    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: 2011-06-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110620000470IOptometryIDTBD

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

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system5453$0
92250Photography of the retina3534$0
92082Exam of visual field with intermediate testing3028$0
View full utilization report →

Insurance plans in this area (ZIP 83401)

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Provider's Procedures

DR. GARY J LATTIMORE (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYID92012Eye and medical examination for diagnosis and treatment, established patient3828

Reviews

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Frequently asked questions

What is the registry number for DR. GARY J LATTIMORE (OD)?
The registry entry for DR. GARY J LATTIMORE (OD) shows NPI 1902863293.
Is DR. GARY J LATTIMORE (OD)'s NPI status active today?
Active status means DR. GARY J LATTIMORE (OD)'s NPI record is not deactivated in the public file.
How should patients interpret DR. GARY J LATTIMORE (OD)'s specialty?
The extract shows Optometrist for DR. GARY J LATTIMORE (OD). Clinical services aligned with this taxonomy classification.
What city is tied to DR. GARY J LATTIMORE (OD)?
The directory associates DR. GARY J LATTIMORE (OD) with Idaho Falls, Idaho. Check all listed addresses for suites or satellite offices.
Can I export DR. GARY J LATTIMORE (OD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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