SHANNON KOENDERS VELDKAMP (OD) – Vision Therapy Optometrist, NPI 1902391626
Vision Therapy Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SHANNON KOENDERS VELDKAMP (OD)
3636 2nd St S
St Cloud, MN 563013732
Phone: (320) 316-9880
Fax: (320) 316-9881
Type: Location
90th Street Northeast, Otsego, Wright County, Minnesota, 55330, United States
OTSEGO, MN 553307448
Phone: (763) 241-1090
Type: Location
11901 CENTRAL PARK WAY UNIT 2313
MAPLE GROVE, MN 553692663
Phone:
Type: Mailing
19879 NAPLES ST NW
ELK RIVER, MN 553308859
Phone: (605) 941-9628
Type: Mailing
12771 RIVERDALE BLVD NW
COON RAPIDS, MN 554481262
Phone: (763) 421-1220
Fax: (763) 421-1291
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $407.
Total Amount is formed as General ($407) + Research ($0) + Ownership ($0) = $407.
Last reported payment date: 2024-09-25 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($195).
Total Amount
$407
General + Research + Ownership
Payments
11
Total payment records
General Amount
$407
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Johnson & Johnson Vision Care, Inc. | $195 |
| Alcon Vision LLC | $176 |
| CooperVision Inc. | $36 |
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: 2020-03-23
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 |
|---|---|---|---|---|
| I20200323000010 | 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 |
|---|---|---|---|---|
| 92004 | New patient complete exam of visual system | 33 | 33 | $0 |
| 92014 | Established patient complete exam of visual system | 28 | 28 | $0 |
Insurance plans in this area (ZIP 56301)
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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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