DR. JACOB ANDREW WOLDT (O.D.) – Optometrist, NPI 1336496355
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
503 OPTOMETRY in IA
Provider Addresses for DR. JACOB ANDREW WOLDT (O.D.)
4405 HAMILTON BLVD
SIOUX CITY, IA 511041140
Phone: (712) 239-3937
Fax: (712) 239-4946
Type: Mailing
1087 W MASON ST
GREEN BAY, WI 543031859
Phone: (920) 499-3102
Fax: (920) 499-9636
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $236.
Total Amount is formed as General ($236) + Research ($0) + Ownership ($0) = $236.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: ABBVIE INC. ($68).
Total Amount
$236
General + Research + Ownership
Payments
11
Total payment records
General Amount
$236
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $68 |
| RxSight Inc | $42 |
| Thea Pharma Inc. | $35 |
| Glaukos Corporation | $29 |
| CooperVision Inc. | $26 |
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: 2020-06-16
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 |
|---|---|---|---|---|
| I20200616002184 | I | Optometry | WI | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 404 | 357 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 206 | 163 | $0 |
| 92250 | Photography of the retina | 148 | 134 | $0 |
| 92133 | Imaging of optic nerve | 119 | 117 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 108 | 108 | $0 |
Insurance plans in this area (ZIP 51104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | WI | |
| - | WI | |
| O P H T H A L M O L O G Y | WI | |
| O P H T H A L M O L O G Y | WI | |
| O P H T H A L M O L O G Y | WI | |
| O P H T H A L M O L O G Y | GA | |
| O P H T H A L M O L O G Y | WI | |
| O P T O M E T R Y | WI |
Reviews
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