COURTLAND J WATSON (OD) – Optometrist, NPI 1093749434

COURTLAND J WATSON (OD) is a healthcare provider. based in Roseville, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2167 (MN). The NPI Number for COURTLAND J WATSON (OD) is 1093749434

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
COURTLAND J WATSON (OD)
NPI
1093749434
Phone
(651) 639-0407
Address
2480 FAIRVIEW AVE N
Enumeration Date
10 July 2006
Last Update Date
31 January 2013

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
9525911970
Graduation Year
1987 (39 years ago)
PAC ID
3870569155
Group Practice PAC ID
7315913670
Professional Enrollment ID
I20100306000278
Address ID
MN553051938MI12513BLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

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Provider Addresses for COURTLAND J WATSON (OD)

  • Lucky's Pub, 2480, Fairview Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States

    ROSEDALE COMMONS

    ROSEVILLE, MN 551132699

    Phone: (651) 639-0407

    Fax: (651) 639-2503

    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 14 Open Payments records for all available years, with a total value of $2,864.

Total Amount is formed as General ($2,864) + Research ($0) + Ownership ($0) = $2,864.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: CooperVision Inc. ($2,543).

Total Amount

$2,864

General + Research + Ownership

Payments

14

Total payment records

General Amount

$2,864

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

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: 2010-03-06

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
I20100306000278IOptometryMNTBD

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 system165165$0
92004New patient complete exam of visual system4040$0
99212Established patient office or other outpatient visit, 10-19 minutes3527$0
92012Established patient problem focused exam of visual system1919$0
View full utilization report →

Insurance plans in this area (ZIP 55113)

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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: 7315913670View full group profile
NameSpecialtyState
-MN
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

Where can patients find COURTLAND J WATSON (OD)'s NPI?
You can confirm COURTLAND J WATSON (OD) with NPI 1093749434; it appears in the national provider directory.
Does this profile mean COURTLAND J WATSON (OD) is currently active?
Yes — COURTLAND J WATSON (OD) appears active in the national provider directory.
Can you summarize COURTLAND J WATSON (OD)'s specialty in plain language?
Clinically, the directory lists COURTLAND J WATSON (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for COURTLAND J WATSON (OD)?
We surface Roseville, Minnesota for COURTLAND J WATSON (OD) based on available NPPES addresses.
Is COURTLAND J WATSON (OD) a real provider?
This page reflects official NPPES data for NPI 1093749434. Always confirm identity and privileges with the practice and licensing boards.

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