BROOKE ELIZABETH PETERSON – Optometrist, NPI 1336945773

BROOKE ELIZABETH PETERSON is a healthcare provider. based in Alton, Illinois. specializing in OPTOMETRY. They hold a License No. 2025024660 (MO). The NPI Number for BROOKE ELIZABETH PETERSON is 1336945773

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
BROOKE ELIZABETH PETERSON
NPI
1336945773
Phone
Not provided
Address
111 E 4TH ST STE 440
Enumeration Date
24 February 2025
Last Update Date
4 July 2025

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
8162292020
Graduation Year
2025 (1 year ago)
PAC ID
5991205890
Group Practice PAC ID
5991856460
Professional Enrollment ID
I20250825002862
Address ID
MO640154610BL1116XHWYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness85
Years active:1State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for BROOKE ELIZABETH PETERSON

  • 111 E 4TH ST STE 440

    ALTON, IL 620026206

    Phone:

    Type: Mailing

  • 1116 SW US HIGHWAY 40

    BLUE SPRINGS, MO 640154610

    Phone: (816) 229-2020

    Type: Location

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: 2025-08-25

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
I20250825002862IOptometryMOTBD

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 62002)

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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: 5991856460View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YMO
-IL
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO

Reviews

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Frequently asked questions

What federal number belongs to BROOKE ELIZABETH PETERSON?
The federal identifier for BROOKE ELIZABETH PETERSON is NPI 1336945773.
Is BROOKE ELIZABETH PETERSON's NPI currently valid?
The extract we use shows BROOKE ELIZABETH PETERSON as active.
Can you summarize BROOKE ELIZABETH PETERSON's specialty in plain language?
Clinically, the directory lists BROOKE ELIZABETH PETERSON with Optometrist. Clinical services aligned with this taxonomy classification.
Where is BROOKE ELIZABETH PETERSON's primary listing?
We display Alton, Illinois because that is what the record indicates for BROOKE ELIZABETH PETERSON.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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