JONATHAN KINGSLEY (OD) – Optometrist, NPI 1033891585

JONATHAN KINGSLEY (OD) is a healthcare provider. based in Council bluffs, Iowa. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 1669 (NE). The NPI Number for JONATHAN KINGSLEY (OD) is 1033891585

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN KINGSLEY (OD)
NPI
1033891585
Phone
(712) 322-3097
Address
2514 W BROADWAY
Enumeration Date
3 August 2023
Last Update Date
12 September 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
4022050754
Graduation Year
2023 (3 years ago)
PAC ID
9032571260
Group Practice PAC ID
7719212307
Professional Enrollment ID
I20250805002720
Address ID
NE681162163OM3606XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:2State licenses:3Digital endpointsOther names

503 OPTOMETRY in IA

Provider Addresses for JONATHAN KINGSLEY (OD)

  • 2514 W BROADWAY

    COUNCIL BLUFFS, IA 515013509

    Phone: (712) 322-3097

    Fax: (712) 322-4130

    Type: Mailing

  • 3606 N 156th St Ste 105

    Omaha, NE 681162163

    Phone: (402) 205-0754

    Type: Location

  • 120 Olson Dr Ste 107

    Papillion, NE 680462961

    Phone: (402) 504-4257

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $247.

Total Amount is formed as General ($247) + Research ($0) + Ownership ($0) = $247.

Last reported payment date: 2024-12-15 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($188).

Total Amount

$247

General + Research + Ownership

Payments

14

Total payment records

General Amount

$247

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-15

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: 2025-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20230818002668IOptometryILTBD
I20250805002720IOptometryNETBD
I20250808000385IOptometryIATBD

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
92250Photography of the retina4440$0
99213Established patient office or other outpatient visit, 20-29 minutes3633$0
99214Established patient office or other outpatient visit, 30-39 minutes3432$0
92081Exam of visual field with limited testing3232$0
View full utilization report →

Insurance plans in this area (ZIP 51501)

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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: 7719212307View full group profile
NameSpecialtyState
O P T O M E T R YNE
O P T O M E T R YMN
O P T O M E T R YIL

Reviews

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Frequently asked questions

What number should I use to identify JONATHAN KINGSLEY (OD) for billing?
Administrative and clinical systems typically use NPI 1033891585 for JONATHAN KINGSLEY (OD).
Is JONATHAN KINGSLEY (OD)'s NPI status active today?
Active status means JONATHAN KINGSLEY (OD)'s NPI record is not deactivated in the public file.
What does the directory say JONATHAN KINGSLEY (OD) does?
Insurance directories may phrase it differently, but here JONATHAN KINGSLEY (OD) maps to Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to JONATHAN KINGSLEY (OD)?
The directory associates JONATHAN KINGSLEY (OD) with Council Bluffs, Iowa. Check all listed addresses for suites or satellite offices.
Who maintains JONATHAN KINGSLEY (OD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.