DR. ANNETTE RENAE GRIMSHAW (OD) – Optometrist, NPI 1104949338

DR. ANNETTE RENAE GRIMSHAW (OD) is a healthcare provider. based in Saint james, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3109 (MN). The NPI Number for DR. ANNETTE RENAE GRIMSHAW (OD) is 1104949338

Main info

Female
25 Years Of Experience
Name
DR. ANNETTE RENAE GRIMSHAW (OD)
NPI
1104949338
Phone
(507) 375-4941
Address
517 1ST AVE S
Enumeration Date
10 April 2007
Last Update Date
20 May 2010

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
8598872441
Graduation Year
2001 (25 years ago)
PAC ID
1557386216
Group Practice PAC ID
0749584977
Professional Enrollment ID
I20241228000187
Address ID
KY403568842NI104XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for DR. ANNETTE RENAE GRIMSHAW (OD)

  • 517 1ST AVE S

    SAINT JAMES, MN 560811727

    Phone: (507) 375-4941

    Fax: (507) 375-3610

    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: 2024-12-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20171201001816IOptometryOHTBD
I20241228000187IOptometryKYTBD

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 minutes3621$0
92250Photography of the retina1815$0
View full utilization report →

Insurance plans in this area (ZIP 56081)

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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: 0749584977View full group profile
NameSpecialtyState
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY

Reviews

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Frequently asked questions

Can I cross-check DR. ANNETTE RENAE GRIMSHAW (OD) using NPI 1104949338?
NPI 1104949338 belongs to DR. ANNETTE RENAE GRIMSHAW (OD); compare other details if you need extra assurance.
Would DR. ANNETTE RENAE GRIMSHAW (OD) appear as active to a payer?
You can treat DR. ANNETTE RENAE GRIMSHAW (OD) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. ANNETTE RENAE GRIMSHAW (OD)?
DR. ANNETTE RENAE GRIMSHAW (OD) is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. ANNETTE RENAE GRIMSHAW (OD)?
Directory geography for DR. ANNETTE RENAE GRIMSHAW (OD) centers on Saint James, Minnesota.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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