DR. JENNIFER WALLER (OD) – Optometrist, NPI 1861440612

DR. JENNIFER WALLER (OD) is a healthcare provider. based in Benld, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046009087 (IL). The NPI Number for DR. JENNIFER WALLER (OD) is 1861440612

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. JENNIFER WALLER (OD)
NPI
1861440612
Phone
(217) 835-7724
Address
600 S 8th St
Enumeration Date
4 May 2006
Last Update Date
3 February 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
2175283233
Graduation Year
1998 (28 years ago)
PAC ID
7618955154
Group Practice PAC ID
3678586187
Professional Enrollment ID
I20040710000271
Address ID
IL627022562SP121XXWXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for DR. JENNIFER WALLER (OD)

  • 600 S 8th St

    Benld, IL 62009

    Phone: (217) 835-7724

    Fax: (217) 835-7611

    Type: Location

  • 600 S 8TH ST

    BENLD, IL 620091446

    Phone: (217) 835-7724

    Fax: (217) 835-7611

    Type: Mailing

  • 2020, West Iles Avenue, Springfield, Sangamon County, Illinois, 62704, United States

    SPRINGFIELD, IL 627044174

    Phone: (217) 698-3030

    Fax: (217) 698-3068

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $57.

Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.

Last reported payment date: 2023-08-21 • Largest payer in this snapshot: Johnson & Johnson Surgical Vision, Inc. ($38).

Total Amount

$57

General + Research + Ownership

Payments

2

Total payment records

General Amount

$57

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-07-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040710000271IOptometryILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system3434$0
92250Photography of the retina2626$0
92012Established patient problem focused exam of visual system2017$0
92004New patient complete exam of visual system1818$0
View full utilization report →

Insurance plans in this area (ZIP 62009)

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Provider's Procedures

DR. JENNIFER WALLER (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYIL92012Eye and medical examination for diagnosis and treatment, established patient183123
OPTOMETRYIL92083Measurement of field of vision during daylight conditions7871

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: 3678586187View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to DR. JENNIFER WALLER (OD)?
NPI 1861440612 is assigned to DR. JENNIFER WALLER (OD) under the national enumeration system.
Is DR. JENNIFER WALLER (OD) currently active in the NPI registry?
CMS-published data lists DR. JENNIFER WALLER (OD) as an active registrant.
Does DR. JENNIFER WALLER (OD) list a primary specialty?
If you are matching referrals, note Optometrist for DR. JENNIFER WALLER (OD). Clinical services aligned with this taxonomy classification.
Does DR. JENNIFER WALLER (OD) practice in Illinois?
You will see Benld, Illinois on file for DR. JENNIFER WALLER (OD) alongside any extra practice locations.
Is DR. JENNIFER WALLER (OD) a real provider?
This page reflects official NPPES data for NPI 1861440612. Always confirm identity and privileges with the practice and licensing boards.

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