DR. ANDREW JACOB POLK (MD) – Ophthalmology Physician, NPI 1528697448
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
444 OPHTHALMOLOGY in MO
Provider Addresses for DR. ANDREW JACOB POLK (MD)
1011 BOWLES AVE STE 200
FENTON, MO 630262384
Phone: (636) 717-1700
Fax: (636) 203-4727
Type: Mailing
1402 S GRAND BLVD # 12
SAINT LOUIS, MO 631041004
Phone: (314) 577-8762
Fax: (314) 268-5108
Type: Mailing
3660 VISTA AVE
SAINT LOUIS, MO 631102540
Phone: (314) 977-6100
Fax: (314) 977-6164
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $980.
Total Amount is formed as General ($980) + Research ($0) + Ownership ($0) = $980.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Alcon Vision LLC ($870).
Total Amount
$980
General + Research + Ownership
Payments
10
Total payment records
General Amount
$980
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $870 |
| Tarsus Pharmaceuticals, Inc. | $110 |
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: 2024-08-29
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 |
|---|---|---|---|---|
| I20240829003948 | I | Ophthalmology | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63026)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| O P H T H A L M O L O G Y | MO | |
| O P H T H A L M O L O G Y | MO | |
| O P T O M E T R Y | MO | |
| O P T O M E T R Y | MO | |
| O P H T H A L M O L O G Y | OK |
Reviews
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