MARTIN J THEOBALD (O.D.) – Optometrist, NPI 1609842210
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
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Provider Addresses for MARTIN J THEOBALD (O.D.)
3308, West Arrowhead Road, Duluth, Saint Louis County, Minnesota, 55811, United States
DULUTH, MN 558114000
Phone: (218) 727-6400
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: 2010-09-22
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20100922000701 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 93 | 92 | $0 |
| 92250 | Photography of the retina | 53 | 52 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 36 | $0 |
| 92083 | Exam of visual field with extended testing | 28 | 26 | $0 |
| 92133 | Imaging of optic nerve | 21 | 20 | $0 |
Insurance plans in this area (ZIP 55811)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN |
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