DR. KAITLYN RENAE GIBSON (OD) – Optometrist, NPI 1992319719

DR. KAITLYN RENAE GIBSON (OD) is a healthcare provider. based in Cedar lake, Indiana. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 18004243A (IN). The NPI Number for DR. KAITLYN RENAE GIBSON (OD) is 1992319719

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. KAITLYN RENAE GIBSON (OD)
NPI
1992319719
Phone
(219) 374-7800
Address
13115 WICKER AVE STE E
Enumeration Date
31 August 2020
Last Update Date
31 August 2020

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
2195950580
Graduation Year
2020 (6 years ago)
PAC ID
2365852464
Group Practice PAC ID
0648521203
Professional Enrollment ID
I20201030001346
Address ID
IN463214059MU10413AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,126 OPTOMETRY in IN

Provider Addresses for DR. KAITLYN RENAE GIBSON (OD)

  • 13115 WICKER AVE STE E

    CEDAR LAKE, IN 463037400

    Phone: (219) 374-7800

    Fax: (219) 374-5196

    Type: Mailing

  • 1001 Main St Ste 1

    Dyer, IN 463111200

    Phone: (219) 322-7800

    Fax: (219) 322-5556

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $13.

Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.

Last reported payment date: 2023-11-13 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($13).

Total Amount

$13

General + Research + Ownership

Payments

1

Total payment records

General Amount

$13

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-13

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: 2020-10-30

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
I20201030001346IOptometryINTBD

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 minutes10580$0
99203New patient office or other outpatient visit, 30-44 minutes2525$0
92133Imaging of optic nerve1312$0
92083Exam of visual field with extended testing1211$0
92134Imaging of retina1212$0
View full utilization report →

Insurance plans in this area (ZIP 46303)

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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: 0648521203View full group profile
NameSpecialtyState
O P T O M E T R YIL

Reviews

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Frequently asked questions

Does DR. KAITLYN RENAE GIBSON (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. KAITLYN RENAE GIBSON (OD) uses 1992319719.
Can I rely on DR. KAITLYN RENAE GIBSON (OD) being an active provider?
As of the registry snapshot, DR. KAITLYN RENAE GIBSON (OD) is marked active.
What is DR. KAITLYN RENAE GIBSON (OD)'s primary classification?
Optometrist is the headline specialty for DR. KAITLYN RENAE GIBSON (OD) here. Clinical services aligned with this taxonomy classification.
Where is DR. KAITLYN RENAE GIBSON (OD) based?
DR. KAITLYN RENAE GIBSON (OD) is tied to Cedar Lake, Indiana in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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