DR. JONATHAN EDWARD MICETICH (O.D.) – Optometrist, NPI 1740273754
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,715 OPTOMETRY in IL
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Provider Addresses for DR. JONATHAN EDWARD MICETICH (O.D.)
2920 GATEWAY GORGE
MORRIS, IL 604509771
Phone: (815) 941-1756
Type: Mailing
20, East North Street, Eileen, Coal City, Grundy County, Illinois, 60416, United States
COAL CITY, IL 604161087
Phone: (815) 634-4825
Fax: (815) 634-4938
Type: Location
1950 OLD GALLOWS RD STE 520
VIENNA, VA 221823970
Phone: (703) 847-8899
Fax: (571) 223-6780
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $85.
Total Amount is formed as General ($85) + Research ($0) + Ownership ($0) = $85.
Last reported payment date: 2024-07-02 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($49).
Total Amount
$85
General + Research + Ownership
Payments
4
Total payment records
General Amount
$85
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $49 |
| Novartis Pharmaceuticals Corporation | $36 |
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: 2011-02-22
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 |
|---|---|---|---|---|
| I20110222000116 | 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 | 2,108 | 17 | $0 |
| 92014 | Established patient complete exam of visual system | 60 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 33 | 20 | $0 |
| 92250 | Photography of the retina | 30 | 30 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 28 | 20 | $0 |
Insurance plans in this area (ZIP 60450)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IL | |
| - | IL | |
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | VA | |
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | IL | |
| - | IL | |
| O P T O M E T R Y | VA |
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