SAMUEL P WHITMORE (OD) – Optometrist, NPI 1003096629

SAMUEL P WHITMORE (OD) is a healthcare provider. based in Des moines, Iowa. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 002398 (IA). The NPI Number for SAMUEL P WHITMORE (OD) is 1003096629

Main info

Male
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL P WHITMORE (OD)
NPI
1003096629
Phone
(515) 279-2020
Address
3725 INGERSOLL AVE
Enumeration Date
12 November 2007
Last Update Date
16 September 2013

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
5152792020
Graduation Year
2007 (19 years ago)
PAC ID
2466521950
Group Practice PAC ID
6608868187
Professional Enrollment ID
I20080523000522
Address ID
IA503123410DE3725XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

503 OPTOMETRY in IA

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Provider Addresses for SAMUEL P WHITMORE (OD)

  • Whylie Eye Care Center, 3725, Ingersoll Avenue, Windsor Terrace Apartments, Des Moines, Polk County, Iowa, 50312, United States

    DES MOINES, IA 503123410

    Phone: (515) 279-2020

    Fax: (515) 255-8002

    Type: Mailing

  • 86th Street, Northpark Business Center, Urbandale, Polk County, Iowa, 50322, United States

    URBANDALE, IA 503224008

    Phone: (515) 270-8545

    Fax: (515) 270-0548

    Type: Location

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: 2008-05-23

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
I20080523000522IOptometryIATBD

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
99214Established patient office or other outpatient visit, 30-39 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 50312)

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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: 6608868187View full group profile
NameSpecialtyState
O P T O M E T R YIA
-IA
O P T O M E T R YIA
O P T O M E T R YIA
O P T O M E T R YIA
O P T O M E T R YIA
O P T O M E T R YIA
O P T O M E T R YIA

Reviews

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Frequently asked questions

What unique ID ties claims to SAMUEL P WHITMORE (OD)?
NPI 1003096629 is assigned to SAMUEL P WHITMORE (OD) under the national enumeration system.
Does this profile mean SAMUEL P WHITMORE (OD) is currently active?
Yes — SAMUEL P WHITMORE (OD) appears active in the national provider directory.
Does SAMUEL P WHITMORE (OD) list a primary specialty?
If you are matching referrals, note Optometrist for SAMUEL P WHITMORE (OD). Clinical services aligned with this taxonomy classification.
Where does public data place SAMUEL P WHITMORE (OD)?
The snapshot lists Des Moines, Iowa for SAMUEL P WHITMORE (OD); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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