TRACY A JACKSON (O.D.) – Optometrist, NPI 1821177692
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
881 OPTOMETRY in MN
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Provider Addresses for TRACY A JACKSON (O.D.)
State Highway 5, Waconia, Carver County, Minnesota, 55387, United States
WACONIA, MN 553871723
Phone: (952) 442-4461
Fax: (952) 442-1218
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: 2004-04-17
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 |
|---|---|---|---|---|
| I20040417000067 | 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 | 162 | 162 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 103 | 87 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 70 | 47 | $0 |
| 92133 | Imaging of optic nerve | 64 | 60 | $0 |
| 92134 | Imaging of retina | 44 | 36 | $0 |
Insurance plans in this area (ZIP 55387)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Family Practice | ID | |
| Family Practice | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| General Surgery | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| Internal Medicine | MN | |
| Internal Medicine | MN | |
| Family Practice | MN |
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