DR. SAMUEL JOSEPH FORZLEY (O.D.) – Optometrist, NPI 1144230392
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. SAMUEL JOSEPH FORZLEY (O.D.)
1192, Walter Street, Lemont, Lemont Township, Cook County, Illinois, 60439, United States
SUITE A
LEMONT, IL 604392903
Phone: (630) 269-8518
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)
CMS reports 43 Open Payments records for all available years, with a total value of $999.
Total Amount is formed as General ($999) + Research ($0) + Ownership ($0) = $999.
Last reported payment date: 2024-09-12 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($214).
Total Amount
$999
General + Research + Ownership
Payments
43
Total payment records
General Amount
$999
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2006-11-10
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 |
|---|---|---|---|---|
| I20061110000206 | I | Optometry | IL | 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 |
|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 4,114 | 37 | $0 |
| 92014 | Established patient complete exam of visual system | 324 | 322 | $0 |
| 92012 | Established patient problem focused exam of visual system | 121 | 97 | $0 |
| 92083 | Exam of visual field with extended testing | 44 | 44 | $0 |
| 92133 | Imaging of optic nerve | 43 | 42 | $0 |
Insurance plans in this area (ZIP 60439)
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Provider's Procedures
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