DR. JENNIFER SUZANNE WADE (O.D.) – Optometrist, NPI 1174622856

DR. JENNIFER SUZANNE WADE (O.D.) is a healthcare provider. based in Goshen, Indiana. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 18002937 (IN). The NPI Number for DR. JENNIFER SUZANNE WADE (O.D.) is 1174622856

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. JENNIFER SUZANNE WADE (O.D.)
NPI
1174622856
Phone
(574) 273-9233
Address
4024 ELKHART RD
Enumeration Date
21 September 2006
Last Update Date
23 March 2017

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
5742437732
Graduation Year
1998 (28 years ago)
PAC ID
8224183660
Group Practice PAC ID
3173673522
Professional Enrollment ID
I20090908000540
Address ID
IN465304474GR155XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,126 OPTOMETRY in IN

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Provider Addresses for DR. JENNIFER SUZANNE WADE (O.D.)

  • Walmart Supercenter, 4024, Elkhart Road, Goshen, Elkhart County, Indiana, 46526, United States

    STE 23

    GOSHEN, IN 465265803

    Phone: (574) 273-9233

    Type: Mailing

  • 175, County Road 6 West, Elkhart, Elkhart County, Indiana, 46514, United States

    ELKHART, IN 465145557

    Phone: (574) 266-7465

    Fax: (574) 266-7467

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $99.

Total Amount is formed as General ($99) + Research ($0) + Ownership ($0) = $99.

Last reported payment date: 2024-03-06 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($50).

Total Amount

$99

General + Research + Ownership

Payments

3

Total payment records

General Amount

$99

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-06

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: 2009-09-08

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
I20090908000540IOptometryINTBD

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 system1212$0
View full utilization report →

Insurance plans in this area (ZIP 46526)

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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: 3173673522View full group profile
NameSpecialtyState
O P T O M E T R YIN

Reviews

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Frequently asked questions

What is the standard ID for DR. JENNIFER SUZANNE WADE (O.D.) in the U.S.?
In the U.S., DR. JENNIFER SUZANNE WADE (O.D.) is identified by NPI 1174622856.
Quick check: is DR. JENNIFER SUZANNE WADE (O.D.) active?
Public NPPES data shows DR. JENNIFER SUZANNE WADE (O.D.) with an active NPI status right now.
What services align with DR. JENNIFER SUZANNE WADE (O.D.)'s listing?
DR. JENNIFER SUZANNE WADE (O.D.)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. JENNIFER SUZANNE WADE (O.D.) tied to Goshen, Indiana?
If you are local to Goshen, Indiana, DR. JENNIFER SUZANNE WADE (O.D.) may be relevant to your search.
Why is information missing for DR. JENNIFER SUZANNE WADE (O.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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