DR. DAVID RAY HAISMAN (OD) – Optometrist, NPI 1104902923
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
49 UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) in IA
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Provider Addresses for DR. DAVID RAY HAISMAN (OD)
Walmart Supercenter, 2200, 17th Street, Spirit Lake, Dickinson County, Iowa, 51360, United States
SPIRIT LAKE, IA 51360
Phone: (712) 336-8939
Fax: (712) 336-8952
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: 2022-03-09
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 |
|---|---|---|---|---|
| I20220309002623 | I | Optometrist | MN | 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 | 186 | 185 | $0 |
| 92134 | Imaging of retina | 48 | 43 | $0 |
| 92012 | Established patient problem focused exam of visual system | 37 | 33 | $0 |
| 92004 | New patient complete exam of visual system | 33 | 33 | $0 |
| 92083 | Exam of visual field with extended testing | 29 | 26 | $0 |
Insurance plans in this area (ZIP 51360)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | IA | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| - | ND | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| - | AZ | |
| Physical Therapist In Private Practice | MN | |
| Nurse Practitioner | SD | |
| Certified Registered Nurse Anesthetist (Crna) | IA | |
| Diagnostic Radiology | SD |
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