DR. KEITH LYSTON (O.D.) – Optometrist, NPI 1861614810

DR. KEITH LYSTON (O.D.) is a healthcare provider. based in Godfrey, Illinois. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. TO3050 (MO). The NPI Number for DR. KEITH LYSTON (O.D.) is 1861614810

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEITH LYSTON (O.D.)
NPI
1861614810
Phone
(618) 466-8787
Address
3300 GODFREY RD
Enumeration Date
2 May 2007
Last Update Date
19 February 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
6184668787
Graduation Year
1992 (34 years ago)
PAC ID
3476648296
Group Practice PAC ID
2961586805
Professional Enrollment ID
I20200210000154
Address ID
IL620352558GO3300XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DR. KEITH LYSTON (O.D.)

  • Godfrey Rd, Godfrey Road, Hiawatha, Minneapolis, Hennepin County, Minnesota, 55406, United States

    GODFREY, IL 620352558

    Phone: (618) 466-8787

    Fax: (618) 466-8787

    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 22 Open Payments records for all available years, with a total value of $670.

Total Amount is formed as General ($670) + Research ($0) + Ownership ($0) = $670.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($478).

Total Amount

$670

General + Research + Ownership

Payments

22

Total payment records

General Amount

$670

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

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: 2020-02-10

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
I20200210000154IOptometryILTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes4031$0
99214Established patient office or other outpatient visit, 30-39 minutes2120$0
92250Photography of the retina1414$0
99204New patient office or other outpatient visit, 45-59 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 62035)

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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: 2961586805View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YMO
O P T O M E T R YIL

Reviews

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Frequently asked questions

Can I use this page to confirm DR. KEITH LYSTON (O.D.)'s NPI?
Yes. DR. KEITH LYSTON (O.D.) is listed with NPI 1861614810 in the public NPI dataset.
Does the file indicate DR. KEITH LYSTON (O.D.) is practicing under active NPI?
Directory data currently reports DR. KEITH LYSTON (O.D.) as active.
What healthcare role does DR. KEITH LYSTON (O.D.) hold?
Scheduling teams often label DR. KEITH LYSTON (O.D.) under Optometrist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. KEITH LYSTON (O.D.)?
DR. KEITH LYSTON (O.D.)'s geographic hint is Godfrey, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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