DR. MICHAEL S PETRONACK (O.D.) – Optometrist, NPI 1295891596

DR. MICHAEL S PETRONACK (O.D.) is a healthcare provider. based in Hugo, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 2544 (MN). The NPI Number for DR. MICHAEL S PETRONACK (O.D.) is 1295891596

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL S PETRONACK (O.D.)
NPI
1295891596
Phone
(651) 762-9545
Address
5679 147TH ST N
Enumeration Date
29 December 2006
Last Update Date
27 June 2013

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
7637843997
Graduation Year
1994 (32 years ago)
PAC ID
8022257633
Group Practice PAC ID
0345220745
Professional Enrollment ID
I20130611000758
Address ID
MN554322614FR7510XNEXX400
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 DR. MICHAEL S PETRONACK (O.D.)

  • 5679, 147th Street North, Hugo, Washington County, Minnesota, 55038, United States

    HUGO, MN 550389302

    Phone: (651) 762-9545

    Fax: (651) 762-9542

    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 3 Open Payments records for all available years, with a total value of $51.

Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.

Last reported payment date: 2024-08-07 • Largest payer in this snapshot: Alcon Vision LLC ($34).

Total Amount

$51

General + Research + Ownership

Payments

3

Total payment records

General Amount

$51

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-07

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: 2013-06-11

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
I20130611000758IOptometryMNTBD

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 system9494$0
92134Imaging of retina2626$0
92004New patient complete exam of visual system1818$0
View full utilization report →

Insurance plans in this area (ZIP 55038)

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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: 0345220745View full group profile
NameSpecialtyState
O P T O M E T R YCT
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 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 YIL

Reviews

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Frequently asked questions

Where can patients find DR. MICHAEL S PETRONACK (O.D.)'s NPI?
You can confirm DR. MICHAEL S PETRONACK (O.D.) with NPI 1295891596; it appears in the national provider directory.
Is DR. MICHAEL S PETRONACK (O.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DR. MICHAEL S PETRONACK (O.D.) work in?
You can think of DR. MICHAEL S PETRONACK (O.D.) as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Where is DR. MICHAEL S PETRONACK (O.D.)'s primary listing?
We display Hugo, Minnesota because that is what the record indicates for DR. MICHAEL S PETRONACK (O.D.).
Is DR. MICHAEL S PETRONACK (O.D.) a real provider?
This page reflects official NPPES data for NPI 1295891596. Always confirm identity and privileges with the practice and licensing boards.

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