DR. BENJAMIN TATSUNORI IWAI (O.D.) – Optometrist, NPI 1417399890

DR. BENJAMIN TATSUNORI IWAI (O.D.) is a healthcare provider. based in Burlington, Iowa. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 002605 (IA). The NPI Number for DR. BENJAMIN TATSUNORI IWAI (O.D.) is 1417399890

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. BENJAMIN TATSUNORI IWAI (O.D.)
NPI
1417399890
Phone
(319) 758-9145
Address
313 N ROOSEVELT AVE
Enumeration Date
25 July 2013
Last Update Date
25 July 2013

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
5734472020
Graduation Year
2013 (13 years ago)
PAC ID
8527294479
Group Practice PAC ID
0244125235
Professional Enrollment ID
I20210324001093
Address ID
MO652032645CO2011XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

503 OPTOMETRY in IA

Provider Addresses for DR. BENJAMIN TATSUNORI IWAI (O.D.)

  • 313 N ROOSEVELT AVE

    BURLINGTON, IA 526011757

    Phone: (319) 758-9145

    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 5 Open Payments records for all available years, with a total value of $280.

Total Amount is formed as General ($280) + Research ($0) + Ownership ($0) = $280.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Ocular Therapeutix, Inc. ($95).

Total Amount

$280

General + Research + Ownership

Payments

5

Total payment records

General Amount

$280

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

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: 2021-03-24

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
I20210324001093IOptometryMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 52601)

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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: 0244125235View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YIL
-MO
-IL
O P T O M E T R YIL
O P T O M E T R YNE
O P T O M E T R YIL
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 YMO

Reviews

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Frequently asked questions

What is DR. BENJAMIN TATSUNORI IWAI (O.D.)'s NPI number?
DR. BENJAMIN TATSUNORI IWAI (O.D.)'s NPI is 1417399890 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to DR. BENJAMIN TATSUNORI IWAI (O.D.)?
You should see DR. BENJAMIN TATSUNORI IWAI (O.D.) as active in CMS-hosted NPPES data.
How would a patient describe DR. BENJAMIN TATSUNORI IWAI (O.D.)'s focus?
For DR. BENJAMIN TATSUNORI IWAI (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. BENJAMIN TATSUNORI IWAI (O.D.) located near Burlington?
DR. BENJAMIN TATSUNORI IWAI (O.D.) currently maps to Burlington, Iowa in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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