DR. WYATT PETERSON (O.D.) – Optometrist, NPI 1902035934
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
Provider Addresses for DR. WYATT PETERSON (O.D.)
9721 Lyndale Ave S
Bloomington, MN 554204232
Phone: (952) 884-8338
Type: Location
1731 17th Ave E
Shakopee, MN 553793372
Phone: (952) 445-5600
Type: Location
7872 Market Blvd
Chanhassen, MN 553179440
Phone: (952) 934-1424
Type: Location
10255, Summer Place, Eden Prairie, Hennepin County, Minnesota, 55347, United States
EDEN PRAIRIE, MN 553474719
Phone: (612) 770-7632
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $190.
Total Amount is formed as General ($190) + Research ($0) + Ownership ($0) = $190.
Last reported payment date: 2024-04-11 • Largest payer in this snapshot: CooperVision Inc. ($174).
Total Amount
$190
General + Research + Ownership
Payments
4
Total payment records
General Amount
$190
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $174 |
| Johnson & Johnson Vision Care, Inc. | $16 |
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: 2009-09-23
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 |
|---|---|---|---|---|
| I20090923000333 | 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 | 150 | 150 | $0 |
| 92133 | Imaging of optic nerve | 49 | 44 | $0 |
| 92083 | Exam of visual field with extended testing | 39 | 27 | $0 |
| 92134 | Imaging of retina | 38 | 34 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 30 | $0 |
Insurance plans in this area (ZIP 55420)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | MO | |
| O P T O M E T R Y | MO | |
| O P T O M E T R Y | MO | |
| O P T O M E T R Y | MO | |
| - | MO | |
| O P T O M E T R Y | MO | |
| - | MO | |
| - | CA | |
| O P T O M E T R Y | MO | |
| O P T O M E T R Y | MO |
Reviews
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