BRETT MATTHEW DEFAUW (OD) – Optometrist, NPI 1639909336

BRETT MATTHEW DEFAUW (OD) is a healthcare provider. based in Eagan, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3955 (MN). The NPI Number for BRETT MATTHEW DEFAUW (OD) is 1639909336

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
BRETT MATTHEW DEFAUW (OD)
NPI
1639909336
Phone
(612) 439-8075
Address
995 Blue Gentian Rd
Enumeration Date
6 August 2024
Last Update Date
6 August 2024

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9522296449
Graduation Year
2021 (5 years ago)
PAC ID
8325587066
Group Practice PAC ID
6305242280
Professional Enrollment ID
I20240827000724
Address ID
MN553374407BU14050DRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for BRETT MATTHEW DEFAUW (OD)

  • 995 Blue Gentian Rd

    Eagan, MN 551211542

    Phone: (612) 439-8075

    Type: Location

  • 50784 BOWER CT

    CHESTERFIELD, MI 480474626

    Phone: (586) 246-3823

    Type: Mailing

  • 14050 BURNHAVEN DR

    BURNSVILLE, MN 553374407

    Phone: (952) 229-6462

    Type: Location

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: 2024-08-27

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
I20240827000724IOptometryMNTBD

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 55121)

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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: 6305242280View full group profile
NameSpecialtyState
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 BRETT MATTHEW DEFAUW (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRETT MATTHEW DEFAUW (OD) uses 1639909336.
Is BRETT MATTHEW DEFAUW (OD) still practicing?
BRETT MATTHEW DEFAUW (OD) is currently listed as active in the public NPI registry.
What is BRETT MATTHEW DEFAUW (OD)'s primary classification?
Optometrist is the headline specialty for BRETT MATTHEW DEFAUW (OD) here. Clinical services aligned with this taxonomy classification.
What address line appears for BRETT MATTHEW DEFAUW (OD)?
BRETT MATTHEW DEFAUW (OD)'s geographic hint is Eagan, Minnesota in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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