MR. CODY MICHAEL BENEDICT (O.D) – Optometrist, NPI 1376146373
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
Provider Addresses for MR. CODY MICHAEL BENEDICT (O.D)
110 EVERGREEN SQ SW
PINE CITY, MN 550632000
Phone: (320) 629-7262
Type: Location
8251 Flying Cloud Dr
Eden Prairie, MN 553445350
Phone: (952) 829-7812
Type: Location
603 OAK ST W UNIT 1
FREDERIC, WI 548378902
Phone: (715) 566-4160
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $152.
Total Amount is formed as General ($152) + Research ($0) + Ownership ($0) = $152.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Alcon Vision LLC ($95).
Total Amount
$152
General + Research + Ownership
Payments
8
Total payment records
General Amount
$152
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $95 |
| Johnson & Johnson Vision Care, Inc. | $40 |
| Oyster Point Pharma, Inc. | $17 |
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: 2022-03-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220324000673 | I | Optometry | MN | TBD |
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.
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 55063)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | CT | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | IL |
Reviews
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