DR. KIMBERLEY ANNE BUGAJSKI (O.D.) – Optometrist, NPI 1962503524

DR. KIMBERLEY ANNE BUGAJSKI (O.D.) is a healthcare provider. based in Plymouth, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. LD2371000 (MN). The NPI Number for DR. KIMBERLEY ANNE BUGAJSKI (O.D.) is 1962503524

Main info

Female
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIMBERLEY ANNE BUGAJSKI (O.D.)
NPI
1962503524
Phone
(763) 545-8850
Address
10600 OLD COUNTY ROAD 15
Enumeration Date
26 September 2006
Last Update Date
10 December 2008

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
7635458850
Graduation Year
1991 (35 years ago)
PAC ID
4587658281
Group Practice PAC ID
9739173659
Professional Enrollment ID
I20040414000871
Address ID
MN554416200PL10600RDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

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Provider Addresses for DR. KIMBERLEY ANNE BUGAJSKI (O.D.)

  • 10600, Old County Road 15, Plymouth, Hennepin County, Minnesota, 55441, United States

    PLYMOUTH, MN 554416210

    Phone: (763) 545-8850

    Fax: (763) 544-1257

    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)

CMS reports 6 Open Payments records for all available years, with a total value of $441.

Total Amount is formed as General ($441) + Research ($0) + Ownership ($0) = $441.

Last reported payment date: 2024-05-29 • Largest payer in this snapshot: Alcon Vision LLC ($291).

Total Amount

$441

General + Research + Ownership

Payments

6

Total payment records

General Amount

$441

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-04-14

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
I20040414000871IOptometryMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system6464$0
99213Established patient office or other outpatient visit, 20-29 minutes3427$0
92250Photography of the retina2827$0
92083Exam of visual field with extended testing2421$0
92020Exam of the internal drainage system of eye1615$0
View full utilization report →

Insurance plans in this area (ZIP 55441)

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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: 9739173659View full group profile
NameSpecialtyState
O P T O M E T R YMN
O P T O M E T R YIL
O P T O M E T R YMN
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

What identifier follows DR. KIMBERLEY ANNE BUGAJSKI (O.D.) across health systems?
The NPI 1962503524 uniquely identifies DR. KIMBERLEY ANNE BUGAJSKI (O.D.) in U.S. healthcare data.
Does the public listing show DR. KIMBERLEY ANNE BUGAJSKI (O.D.) as active?
DR. KIMBERLEY ANNE BUGAJSKI (O.D.)'s NPI record reflects an active status in NPPES.
What type of care does DR. KIMBERLEY ANNE BUGAJSKI (O.D.) provide?
DR. KIMBERLEY ANNE BUGAJSKI (O.D.)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. KIMBERLEY ANNE BUGAJSKI (O.D.)?
DR. KIMBERLEY ANNE BUGAJSKI (O.D.) shows a connection to Plymouth, Minnesota in registry-derived data.
Why is information missing for DR. KIMBERLEY ANNE BUGAJSKI (O.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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