NICHOLAS E. BANTZ (OD) – Optometrist, NPI 1063254829

NICHOLAS E. BANTZ (OD) is a healthcare provider. based in Greenwood, Indiana. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 18004499A (IN). The NPI Number for NICHOLAS E. BANTZ (OD) is 1063254829

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS E. BANTZ (OD)
NPI
1063254829
Phone
(317) 865-6829
Address
2887 S STATE ROAD 135
Enumeration Date
11 June 2024
Last Update Date
11 June 2024

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
7654468010
Graduation Year
2024 (2 years ago)
PAC ID
5799229092
Group Practice PAC ID
6800281825
Professional Enrollment ID
I20240627002093
Address ID
IN479055109LA2141XSXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,126 OPTOMETRY in IN

Provider Addresses for NICHOLAS E. BANTZ (OD)

  • 2887 S STATE ROAD 135

    GREENWOOD, IN 461439604

    Phone: (317) 865-6829

    Fax: (317) 886-7955

    Type: Mailing

  • 13840 E 96TH ST

    MCCORDSVILLE, IN 460559394

    Phone: (317) 720-2020

    Fax: (317) 886-7955

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $244.

Total Amount is formed as General ($244) + Research ($0) + Ownership ($0) = $244.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($170).

Total Amount

$244

General + Research + Ownership

Payments

6

Total payment records

General Amount

$244

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

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: 2024-06-27

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
I20240627002093IOptometryINTBD

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 46143)

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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: 6800281825View full group profile
NameSpecialtyState
O P T O M E T R YWA
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YKY
O P T O M E T R YTX

Reviews

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Frequently asked questions

What NPI should I save for NICHOLAS E. BANTZ (OD)?
Save NPI 1063254829 if you need a stable reference for NICHOLAS E. BANTZ (OD).
Is NICHOLAS E. BANTZ (OD)'s NPI currently valid?
The extract we use shows NICHOLAS E. BANTZ (OD) as active.
Does NICHOLAS E. BANTZ (OD) list a primary specialty?
If you are matching referrals, note Optometrist for NICHOLAS E. BANTZ (OD). Clinical services aligned with this taxonomy classification.
Does NICHOLAS E. BANTZ (OD) practice in Indiana?
You will see Greenwood, Indiana on file for NICHOLAS E. BANTZ (OD) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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