DR. DUSTIN J GARDNER (O.D.) – Optometrist, NPI 1366720922

DR. DUSTIN J GARDNER (O.D.) is a healthcare provider. based in Ballwin, Missouri. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 6041 (OH). The NPI Number for DR. DUSTIN J GARDNER (O.D.) is 1366720922

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. DUSTIN J GARDNER (O.D.)
NPI
1366720922
Phone
(636) 200-4393
Address
15933 CLAYTON RD
Enumeration Date
1 August 2011
Last Update Date
4 October 2016

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
4196293241
Graduation Year
2011 (15 years ago)
PAC ID
8123290285
Group Practice PAC ID
2860826757
Professional Enrollment ID
I20111013000577
Address ID
OH458691254NE431XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,618 OPTOMETRY in OH

Provider Addresses for DR. DUSTIN J GARDNER (O.D.)

  • 15933 CLAYTON RD

    SUITE 201

    BALLWIN, MO 630112172

    Phone: (636) 200-4393

    Fax: (636) 527-0766

    Type: Mailing

  • 105 MOREY DR

    MARYSVILLE, OH 430401647

    Phone: (937) 642-1916

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $3,391.

Total Amount is formed as General ($3,391) + Research ($0) + Ownership ($0) = $3,391.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($3,262).

Total Amount

$3,391

General + Research + Ownership

Payments

19

Total payment records

General Amount

$3,391

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

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: 2011-10-13

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
I20111013000577IOptometryOHTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes131117$0
99213Established patient office or other outpatient visit, 20-29 minutes6956$0
92134Imaging of retina1717$0
92083Exam of visual field with extended testing1616$0
92133Imaging of optic nerve1515$0
View full utilization report →

Insurance plans in this area (ZIP 63011)

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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: 2860826757View full group profile
NameSpecialtyState
-OH
O P T O M E T R YOH
O P T O M E T R YOH

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. DUSTIN J GARDNER (O.D.)?
DR. DUSTIN J GARDNER (O.D.) — NPI 1366720922 — is the standard way to identify this listing.
Does CMS list DR. DUSTIN J GARDNER (O.D.) as active?
Yes — DR. DUSTIN J GARDNER (O.D.) is active in the NPI listing used on this page.
What is DR. DUSTIN J GARDNER (O.D.) best known for clinically?
Directory data describes DR. DUSTIN J GARDNER (O.D.) with Optometrist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. DUSTIN J GARDNER (O.D.)?
DR. DUSTIN J GARDNER (O.D.)'s geographic hint is Ballwin, Missouri in our summary view.
Is the information about DR. DUSTIN J GARDNER (O.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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