MARY LEANN BOOMER (O.D.) – Optometrist, NPI 1285256859

MARY LEANN BOOMER (O.D.) is a healthcare provider. based in Traverse city, Michigan. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 4901005448 (MI). The NPI Number for MARY LEANN BOOMER (O.D.) is 1285256859

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MARY LEANN BOOMER (O.D.)
NPI
1285256859
Phone
(231) 947-6246
Address
929 BUSINESS PARK DR
Enumeration Date
17 May 2020
Last Update Date
3 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319324336
Graduation Year
2020 (6 years ago)
PAC ID
5890118608
Group Practice PAC ID
4981503521
Professional Enrollment ID
I20200713002712
Address ID
MI496868683TR929XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,203 OPTOMETRY in MI

Provider Addresses for MARY LEANN BOOMER (O.D.)

  • 929 BUSINESS PARK DR

    TRAVERSE CITY, MI 496868683

    Phone: (231) 947-6246

    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 6 Open Payments records for all available years, with a total value of $114.

Total Amount is formed as General ($114) + Research ($0) + Ownership ($0) = $114.

Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Alcon Vision LLC ($58).

Total Amount

$114

General + Research + Ownership

Payments

6

Total payment records

General Amount

$114

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-13

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: 2020-07-13

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
I20200713002712IOptometryMITBD

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
92014Established patient complete exam of visual system105103$0
99213Established patient office or other outpatient visit, 20-29 minutes4338$0
92004New patient complete exam of visual system3838$0
92134Imaging of retina2927$0
View full utilization report →

Insurance plans in this area (ZIP 49686)

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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: 4981503521View 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 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 YMI
O P T O M E T R YMI
O P T O M E T R YMO
-MI
O P H T H A L M O L O G YMI

Reviews

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Frequently asked questions

What is the standard ID for MARY LEANN BOOMER (O.D.) in the U.S.?
In the U.S., MARY LEANN BOOMER (O.D.) is identified by NPI 1285256859.
Is MARY LEANN BOOMER (O.D.)'s NPI status active today?
Active status means MARY LEANN BOOMER (O.D.)'s NPI record is not deactivated in the public file.
Which specialty label fits MARY LEANN BOOMER (O.D.)?
NPPES ties MARY LEANN BOOMER (O.D.) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is MARY LEANN BOOMER (O.D.) tied to Traverse City, Michigan?
If you are local to Traverse City, Michigan, MARY LEANN BOOMER (O.D.) may be relevant to your search.
Can I export MARY LEANN BOOMER (O.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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