DR. MALLORY MATHIS (OD) – Optometrist, NPI 1134805633
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
957 OPTOMETRY in TN
Provider Addresses for DR. MALLORY MATHIS (OD)
111 E 4TH ST STE 440
ALTON, IL 620026206
Phone: (618) 462-9818
Fax: (314) 741-4947
Type: Mailing
215 HOLLY LN
WAVERLY, TN 371853387
Phone: (931) 296-1990
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $310.
Total Amount is formed as General ($310) + Research ($0) + Ownership ($0) = $310.
Last reported payment date: 2024-07-25 • Largest payer in this snapshot: BIOTISSUE HOLDINGS INC. ($173).
Total Amount
$310
General + Research + Ownership
Payments
10
Total payment records
General Amount
$310
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| BIOTISSUE HOLDINGS INC. | $173 |
| Alcon Vision LLC | $58 |
| Johnson & Johnson Vision Care, Inc. | $41 |
| Bausch & Lomb Americas Inc. | $39 |
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: 2023-08-28
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 |
|---|---|---|---|---|
| I20230828000157 | I | Optometry | TN | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 29 | 22 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 22 | 21 | $0 |
| 92014 | Established patient complete exam of visual system | 21 | 21 | $0 |
| 92250 | Photography of the retina | 12 | 12 | $0 |
Insurance plans in this area (ZIP 62002)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | TN | |
| - | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| - | TN | |
| O P T O M E T R Y | TN | |
| - | TN | |
| - | TN |
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