JORDAN FREDERICK KEITH (O.D.) – Optometrist, NPI 1861646937
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 JORDAN FREDERICK KEITH (O.D.)
Moore Lake Dr E, Central Avenue Northeast, Fridley, Anoka County, Minnesota, 55432, United States
FRIDLEY, MN 554325170
Phone: (763) 574-0075
Fax: (763) 574-0594
Type: Location
2514 W Broadway
Council Bluffs, IA 515013509
Phone: (712) 322-3097
Type: Location
120 Olson Dr Ste 107
Papillion, NE 680462961
Phone: (402) 504-4257
Type: Location
3606 N 156TH ST STE 105
OMAHA, NE 681162163
Phone: (402) 205-0754
Type: Mailing
3606 N 156TH ST
OMAHA, NE 681162158
Phone: (402) 205-0754
Type: Location
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 $149.
Total Amount is formed as General ($149) + Research ($0) + Ownership ($0) = $149.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($149).
Total Amount
$149
General + Research + Ownership
Payments
3
Total payment records
General Amount
$149
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Johnson & Johnson Vision Care, Inc. | $149 |
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: 2022-10-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20220923001449 | I | Optometry | IA | TBD |
| I20221018001896 | I | Optometry | NE | 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 | 40 | 39 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 36 | 29 | $0 |
| 92250 | Photography of the retina | 36 | 33 | $0 |
| 92134 | Imaging of retina | 19 | 14 | $0 |
| 92133 | Imaging of optic nerve | 13 | 13 | $0 |
Insurance plans in this area (ZIP 55432)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IA | |
| O P T O M E T R Y | NE | |
| O P T O M E T R Y | IL |
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