PENELOPE ANN HAEKER (OD) – Optometrist, NPI 1326040361
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
503 OPTOMETRY in IA
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Provider Addresses for PENELOPE ANN HAEKER (OD)
Gordmans, 5001, Sergeant Road, Lakeport Commons Shopping Center, Sioux City, Woodbury County, Iowa, 51106, United States
SUITE 45
SIOUX CITY, IA 511064775
Phone: (712) 224-4600
Fax: (712) 276-3716
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)
CMS reports 8 Open Payments records for all available years, with a total value of $237.
Total Amount is formed as General ($237) + Research ($0) + Ownership ($0) = $237.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Mallinckrodt Hospital Products Inc. ($196).
Total Amount
$237
General + Research + Ownership
Payments
8
Total payment records
General Amount
$237
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mallinckrodt Hospital Products Inc. | $196 |
| Astellas Pharma US Inc | $42 |
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: 2022-09-22
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 |
|---|---|---|---|---|
| I20220922001472 | I | Optometry | SD | 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 |
|---|---|---|---|---|
| 92004 | New patient complete exam of visual system | 97 | 97 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 31 | 25 | $0 |
| 66984 | Removal of cataract with insertion of prosthetic lens | 30 | 17 | $0 |
| 92014 | Established patient complete exam of visual system | 26 | 26 | $0 |
| 92134 | Imaging of retina | 19 | 18 | $0 |
Insurance plans in this area (ZIP 51106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | SD | |
| O P T O M E T R Y | SD |
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