COLIN N JACK (O.D.) – Optometrist, NPI 1700853637
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for COLIN N JACK (O.D.)
Burlington Beach Road, Valparaiso, Porter County, Indiana, 46383, United States
VALPARAISO, IN 463830000
Phone: (219) 462-0309
Fax: (219) 464-4291
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)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2010-01-22
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 |
|---|---|---|---|---|
| I20100122000322 | I | Optometry | IN | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 163 | 162 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 35 | 27 | $0 |
| 92134 | Imaging of retina | 33 | 32 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 29 | $0 |
| 92012 | Established patient problem focused exam of visual system | 25 | 22 | $0 |
Insurance plans in this area (ZIP 46383)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | IN | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 42 | 33 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IN | |
| O P H T H A L M O L O G Y | IN | |
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P H T H A L M O L O G Y | IN | |
| O P H T H A L M O L O G Y | IN |
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