DR. CHAD R. DOCKTER (OD) – Optometrist, NPI 1104975762

DR. CHAD R. DOCKTER (OD) is a healthcare provider. based in Eden prairie, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2439 (MN). The NPI Number for DR. CHAD R. DOCKTER (OD) is 1104975762

Main info

Male
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHAD R. DOCKTER (OD)
NPI
1104975762
Phone
(952) 563-0247
Address
TARGET OPTICAL
Enumeration Date
10 January 2007
Last Update Date
16 November 2012

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9524663937
Graduation Year
1993 (33 years ago)
PAC ID
5597799395
Group Practice PAC ID
9032010251
Professional Enrollment ID
I20050921000801
Address ID
MN553182749CH1200XWAYX401
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

Provider Addresses for DR. CHAD R. DOCKTER (OD)

  • TARGET OPTICAL

    8225 FLYING CLOUD DRIVE

    EDEN PRAIRIE, MN 55344

    Phone: (952) 563-0247

    Type: Location

  • 1464, White Oak Drive, Jonathan, Chaska, Carver County, Minnesota, 55318, United States

    CHASKA, MN 55318

    Phone: (952) 466-3937

    Fax: (952) 466-3936

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $1,205.

Total Amount is formed as General ($1,205) + Research ($0) + Ownership ($0) = $1,205.

Last reported payment date: 2024-10-08 • Largest payer in this snapshot: Alcon Vision LLC ($722).

Total Amount

$1,205

General + Research + Ownership

Payments

10

Total payment records

General Amount

$1,205

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-08

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: 2005-09-21

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
I20050921000801IOptometryMNTBD

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
66984Removal of cataract with insertion of prosthetic lens1,89016$0
92014Established patient complete exam of visual system7575$0
99213Established patient office or other outpatient visit, 20-29 minutes4430$0
99212Established patient office or other outpatient visit, 10-19 minutes3425$0
92133Imaging of optic nerve2019$0
View full utilization report →

Insurance plans in this area (ZIP 55344)

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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: 9032010251View full group profile
NameSpecialtyState
O P H T H A L M O L O G YMN
O P H T H A L M O L O G 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
O P T O M E T R YMN
O P T O M E T R YMN
O P H T H A L M O L O G YTX
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

Does DR. CHAD R. DOCKTER (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. CHAD R. DOCKTER (OD) uses 1104975762.
Can I rely on DR. CHAD R. DOCKTER (OD) being an active provider?
As of the registry snapshot, DR. CHAD R. DOCKTER (OD) is marked active.
What is DR. CHAD R. DOCKTER (OD)'s primary classification?
Optometrist is the headline specialty for DR. CHAD R. DOCKTER (OD) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. CHAD R. DOCKTER (OD)?
DR. CHAD R. DOCKTER (OD)'s geographic hint is Eden Prairie, Minnesota in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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