PHILIP PELTON – Optometrist, NPI 1275117319

PHILIP PELTON is a healthcare provider. based in Portage, Michigan. specializing in OPTOMETRY. They hold a License No. 4901005543 (MI). The NPI Number for PHILIP PELTON is 1275117319

Main info

Male
5 Years Of Experience
Name
PHILIP PELTON
NPI
1275117319
Phone
(269) 324-0800
Address
255 ROMENCE RD
Enumeration Date
5 May 2021
Last Update Date
14 November 2025

Doctor Profile

Medical School Name
FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Secondary Phone
5177829436
Graduation Year
2021 (5 years ago)
PAC ID
7618376484
Group Practice PAC ID
4486566098
Professional Enrollment ID
I20210527000783
Address ID
MI492024240JA1116XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Digital endpointsOther names

1,204 OPTOMETRY in MI

Provider Addresses for PHILIP PELTON

  • 255 ROMENCE RD

    PORTAGE, MI 490243439

    Phone: (269) 324-0800

    Fax: (269) 324-0894

    Type: Location

  • PO BOX 207170

    DALLAS, TX 753207170

    Phone: (636) 200-4393

    Fax: (636) 527-0766

    Type: Mailing

  • 56847 N MAIN ST

    THREE RIVERS, MI 490939615

    Phone: (269) 273-2020

    Type: Location

  • 8614 WESTWOOD CENTER DR FL 9

    VIENNA, VA 221822442

    Phone: (703) 847-8899

    Fax: (571) 223-6780

    Type: Mailing

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 $596.

Total Amount is formed as General ($596) + Research ($0) + Ownership ($0) = $596.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: CooperVision Inc. ($245).

Total Amount

$596

General + Research + Ownership

Payments

8

Total payment records

General Amount

$596

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

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: 2021-05-27

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
I20210527000783IOptometryMITBD

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
99213Established patient office or other outpatient visit, 20-29 minutes1715$0
View full utilization report →

Insurance plans in this area (ZIP 49024)

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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: 4486566098View full group profile
NameSpecialtyState
O P T O M E T R YMI
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YKY
O P T O M E T R YMI
O P T O M E T R YMI
O P H T H A L M O L O G YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P H T H A L M O L O G YMI

Reviews

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Frequently asked questions

How do I look up PHILIP PELTON by NPI?
Use NPI 1275117319 when you need to reference PHILIP PELTON in forms, claims, or directories.
Is PHILIP PELTON active in the national directory?
PHILIP PELTON's public NPI profile is in an active state.
What field does PHILIP PELTON work in?
You can think of PHILIP PELTON as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for PHILIP PELTON?
The page summarizes Portage, Michigan for PHILIP PELTON; expand the address list for detail.
What if Portage, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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