DR. JENNIFER ELAM (O.D.) – Optometrist, NPI 1356443261
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JENNIFER ELAM (O.D.)
3560, Pine Grove Avenue, Port Huron, Saint Clair County, Michigan, 48060, United States
STE 366
PORT HURON, MI 480601994
Phone: (502) 759-1123
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)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20140404000252 | I | Optometry | MN | TBD |
| I20191112000208 | I | Optometry | MI | TBD |
| I20230104002014 | I | Optometry | WI | 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 |
|---|---|---|---|---|
| 92004 | New patient complete exam of visual system | 349 | 349 | $0 |
| 92014 | Established patient complete exam of visual system | 301 | 292 | $0 |
| 92250 | Photography of the retina | 299 | 293 | $0 |
| 65778 | Placement of amniotic membrane on eye surface for wound healing | 150 | 132 | $0 |
| 92012 | Established patient problem focused exam of visual system | 117 | 111 | $0 |
Insurance plans in this area (ZIP 48060)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | MI | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 49 | 48 |
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