DR. KEVIN ALLEN SKIDMORE (O.D.) – Optometrist, NPI 1093060188

DR. KEVIN ALLEN SKIDMORE (O.D.) is a healthcare provider. based in Berea, Kentucky. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPT.6159-THER (OH). The NPI Number for DR. KEVIN ALLEN SKIDMORE (O.D.) is 1093060188

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEVIN ALLEN SKIDMORE (O.D.)
NPI
1093060188
Phone
(859) 986-7027
Address
854 RIDGEWOOD DRIVE
Enumeration Date
16 July 2012
Last Update Date
17 September 2020

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
8599867027
Graduation Year
2012 (14 years ago)
PAC ID
7416190285
Group Practice PAC ID
8628138229
Professional Enrollment ID
I20130826000919
Address ID
KY404039814BE854XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:13State licenses:2Digital endpointsOther names

700 OPTOMETRY in KY

Provider Addresses for DR. KEVIN ALLEN SKIDMORE (O.D.)

  • 854 RIDGEWOOD DRIVE

    BEREA, KY 40403

    Phone: (859) 986-7027

    Fax: (859) 986-4749

    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 18 Open Payments records for all available years, with a total value of $514.

Total Amount is formed as General ($514) + Research ($0) + Ownership ($0) = $514.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($300).

Total Amount

$514

General + Research + Ownership

Payments

18

Total payment records

General Amount

$514

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2013-08-26

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
I20130826000919IOptometryKYTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens1,56014$0
92014Established patient complete exam of visual system7069$0
92250Photography of the retina5448$0
99213Established patient office or other outpatient visit, 20-29 minutes5137$0
66821Removal of recurring cataract in lens capsule using a laser3223$0
View full utilization report →

Insurance plans in this area (ZIP 40403)

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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: 8628138229View full group profile
NameSpecialtyState
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY

Reviews

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Frequently asked questions

How do payers reference DR. KEVIN ALLEN SKIDMORE (O.D.)?
For DR. KEVIN ALLEN SKIDMORE (O.D.), use NPI 1093060188 as the unique 10-digit identifier.
Is DR. KEVIN ALLEN SKIDMORE (O.D.) shown as active in public data?
Registry records indicate DR. KEVIN ALLEN SKIDMORE (O.D.) maintains an active NPI.
What clinical focus is listed for DR. KEVIN ALLEN SKIDMORE (O.D.)?
At a glance, DR. KEVIN ALLEN SKIDMORE (O.D.) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. KEVIN ALLEN SKIDMORE (O.D.) located near Berea?
DR. KEVIN ALLEN SKIDMORE (O.D.) currently maps to Berea, Kentucky 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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