ANDREW PETERSON (OD) – Optometrist, NPI 1194608422

ANDREW PETERSON (OD) is a healthcare provider. based in Arlington heights, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046012014 (IL). The NPI Number for ANDREW PETERSON (OD) is 1194608422

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ANDREW PETERSON (OD)
NPI
1194608422
Phone
(847) 253-4040
Address
1100 W CENTRAL RD STE 205
Enumeration Date
25 July 2025
Last Update Date
25 July 2025

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
8472900202
Graduation Year
2025 (1 year ago)
PAC ID
0244733715
Group Practice PAC ID
5294740320
Professional Enrollment ID
I20250911000803
Address ID
IL600073311EL800XXRDXX306
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for ANDREW PETERSON (OD)

  • 1100 W CENTRAL RD STE 205

    ARLINGTON HEIGHTS, IL 600052465

    Phone: (847) 253-4040

    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: 2025-09-11

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
I20250911000803IOptometryILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60005)

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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: 5294740320View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL

Reviews

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Frequently asked questions

What is the standard ID for ANDREW PETERSON (OD) in the U.S.?
In the U.S., ANDREW PETERSON (OD) is identified by NPI 1194608422.
Does the public listing show ANDREW PETERSON (OD) as active?
ANDREW PETERSON (OD)'s NPI record reflects an active status in NPPES.
What services align with ANDREW PETERSON (OD)'s listing?
ANDREW PETERSON (OD)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to ANDREW PETERSON (OD)?
The directory associates ANDREW PETERSON (OD) with Arlington Heights, Illinois. Check all listed addresses for suites or satellite offices.
Why is information missing for ANDREW PETERSON (OD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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