DR. KELLY N JANSMA (OD) – Optometrist, NPI 1649229857
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 DR. KELLY N JANSMA (OD)
1620, North Ankeny Boulevard, Ankeny, Polk County, Iowa, 50023, United States
STE 106
ANKENY, IA 500234111
Phone: (515) 963-7902
Fax: (844) 493-4932
Type: Mailing
North Ankeny Boulevard, Ankeny, Polk County, Iowa, 50021, United States
ANKENY, IA 500234111
Phone: (515) 963-7902
Fax: (844) 493-4932
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $371.
Total Amount is formed as General ($371) + Research ($0) + Ownership ($0) = $371.
Last reported payment date: 2024-10-01 • Largest payer in this snapshot: Alcon Vision LLC ($293).
Total Amount
$371
General + Research + Ownership
Payments
10
Total payment records
General Amount
$371
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $293 |
| CooperVision Inc. | $62 |
| Tarsus Pharmaceuticals, Inc. | $16 |
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: 2004-11-03
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 |
|---|---|---|---|---|
| I20041103000502 | I | Optometry | IA | 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 | 71 | 70 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 37 | $0 |
| 92250 | Photography of the retina | 28 | 28 | $0 |
| 92004 | New patient complete exam of visual system | 16 | 16 | $0 |
Insurance plans in this area (ZIP 50023)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | IA | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 21 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | TX | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | IA |
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