DR. VIVIAN OWANIMEDU EKEMEZIE (O.D) – Optometrist, NPI 1194070490

DR. VIVIAN OWANIMEDU EKEMEZIE (O.D) is a healthcare provider. based in Blaine, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D. They hold a License No. 3311 (MN). The NPI Number for DR. VIVIAN OWANIMEDU EKEMEZIE (O.D) is 1194070490

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)
NPI
1194070490
Phone
(763) 843-7153
Address
1036 97TH LN NE
Enumeration Date
23 July 2012
Last Update Date
14 March 2025

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
6127881621
Graduation Year
2012 (14 years ago)
PAC ID
0749434793
Group Practice PAC ID
8729000435
Professional Enrollment ID
I20130129000372
Address ID
MN554213425MI4001XBLVD302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)

  • 1036 97TH LN NE

    BLAINE, MN 554343515

    Phone: (763) 843-7153

    Type: Mailing

  • 215 BALSAM ST N

    CAMBRIDGE, MN 550085814

    Phone: (763) 689-5576

    Type: Location

  • 9113 ASHLEY TER

    BROOKLYN PARK, MN 554431714

    Phone:

    Type: Mailing

  • 825 NICOLLET MALL

    MINNEAPOLIS, MN 554022606

    Phone: (612) 338-4861

    Fax: (612) 333-8306

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $33.

Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Alcon Vision LLC ($33).

Total Amount

$33

General + Research + Ownership

Payments

1

Total payment records

General Amount

$33

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alcon Vision LLC$33
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: 2013-01-29

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
I20130129000372IOptometryMNTBD

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 55434)

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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: 8729000435View 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 YCO
O P H T H A L M O L O G YMN
-MN
O P T O M E T R YMN
O P H T H A L M O L O G YMN
-MN

Reviews

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Frequently asked questions

How do payers reference DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)?
For DR. VIVIAN OWANIMEDU EKEMEZIE (O.D), use NPI 1194070490 as the unique 10-digit identifier.
Active or inactive — what applies to DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)?
You should see DR. VIVIAN OWANIMEDU EKEMEZIE (O.D) as active in CMS-hosted NPPES data.
How would a patient describe DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)'s focus?
For DR. VIVIAN OWANIMEDU EKEMEZIE (O.D), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)?
Directory geography for DR. VIVIAN OWANIMEDU EKEMEZIE (O.D) centers on Blaine, Minnesota.
Can I trust this NPI listing for DR. VIVIAN OWANIMEDU EKEMEZIE (O.D)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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