DR. MICHAEL R MONTGOMERY (OD) – Optometrist, NPI 1124002969

DR. MICHAEL R MONTGOMERY (OD) is a healthcare provider. based in Lebanon, Missouri. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. T02552 (MO). The NPI Number for DR. MICHAEL R MONTGOMERY (OD) is 1124002969

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL R MONTGOMERY (OD)
NPI
1124002969
Phone
(417) 532-2562
Address
279 E ELM ST
Enumeration Date
5 December 2005
Last Update Date
27 November 2012

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
4175322562
Graduation Year
1983 (43 years ago)
PAC ID
0244338309
Professional Enrollment ID
I20070615000442
Address ID
MO655363610LE279XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

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Provider Addresses for DR. MICHAEL R MONTGOMERY (OD)

  • 279, East Elm Street, Lebanon, Lebanon County, Pennsylvania, 17042, United States

    LEBANON, MO 655363610

    Phone: (417) 532-2562

    Fax: (417) 532-2409

    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 7 Open Payments records for all available years, with a total value of $230.

Total Amount is formed as General ($230) + Research ($0) + Ownership ($0) = $230.

Last reported payment date: 2024-09-13 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($205).

Total Amount

$230

General + Research + Ownership

Payments

7

Total payment records

General Amount

$230

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-13

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: 2007-06-15

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
I20070615000442IOptometryMOTBD

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 system127126$0
99214Established patient office or other outpatient visit, 30-39 minutes2020$0
66984Removal of cataract with insertion of prosthetic lens1912$0
92004New patient complete exam of visual system1919$0
99213Established patient office or other outpatient visit, 20-29 minutes1514$0
View full utilization report →

Insurance plans in this area (ZIP 65536)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MICHAEL R MONTGOMERY (OD)?
DR. MICHAEL R MONTGOMERY (OD) — NPI 1124002969 — is the standard way to identify this listing.
Does the file indicate DR. MICHAEL R MONTGOMERY (OD) is practicing under active NPI?
Directory data currently reports DR. MICHAEL R MONTGOMERY (OD) as active.
What is DR. MICHAEL R MONTGOMERY (OD)'s primary classification?
Optometrist is the headline specialty for DR. MICHAEL R MONTGOMERY (OD) here. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MICHAEL R MONTGOMERY (OD) on a map?
Expect Lebanon, Missouri as a primary anchor for DR. MICHAEL R MONTGOMERY (OD) unless the record lists multiple sites.
Is the information about DR. MICHAEL R MONTGOMERY (OD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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