DR. ALEXIS KIM NIVAUD (OD) – Optometrist, NPI 1053152496

DR. ALEXIS KIM NIVAUD (OD) is a healthcare provider. based in Lakeville, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3934 (MN). The NPI Number for DR. ALEXIS KIM NIVAUD (OD) is 1053152496

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALEXIS KIM NIVAUD (OD)
NPI
1053152496
Phone
(952) 469-3937
Address
20094 KENWOOD TRL
Enumeration Date
31 May 2024
Last Update Date
31 May 2024

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
9524693937
Graduation Year
2024 (2 years ago)
PAC ID
7618411893
Group Practice PAC ID
5395888002
Professional Enrollment ID
I20240628000778
Address ID
MN550445404LA20094TRLX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for DR. ALEXIS KIM NIVAUD (OD)

  • 20094 KENWOOD TRL

    LAKEVILLE, MN 550445404

    Phone: (952) 469-3937

    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 4 Open Payments records for all available years, with a total value of $174.

Total Amount is formed as General ($174) + Research ($0) + Ownership ($0) = $174.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: CooperVision Inc. ($116).

Total Amount

$174

General + Research + Ownership

Payments

4

Total payment records

General Amount

$174

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

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: 2024-06-28

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
I20240628000778IOptometryMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55044)

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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: 5395888002View full group profile
NameSpecialtyState
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN

Reviews

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Frequently asked questions

What federal number belongs to DR. ALEXIS KIM NIVAUD (OD)?
The federal identifier for DR. ALEXIS KIM NIVAUD (OD) is NPI 1053152496.
Does this profile mean DR. ALEXIS KIM NIVAUD (OD) is currently active?
Yes — DR. ALEXIS KIM NIVAUD (OD) appears active in the national provider directory.
What does DR. ALEXIS KIM NIVAUD (OD) treat or focus on?
Patients typically see DR. ALEXIS KIM NIVAUD (OD) under the specialty Optometrist. Clinical services aligned with this taxonomy classification.
Does DR. ALEXIS KIM NIVAUD (OD) practice in Minnesota?
You will see Lakeville, Minnesota on file for DR. ALEXIS KIM NIVAUD (OD) alongside any extra practice locations.
What if Lakeville, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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