DR. JACQUELYN ANN BONGARD (OD) – Optometrist, NPI 1588341192
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
863 OPTOMETRY in MO
Provider Addresses for DR. JACQUELYN ANN BONGARD (OD)
3940 Lindell Blvd
Saint Louis, MO 631083204
Phone: (314) 516-5131
Fax: (314) 516-5507
Type: Location
2421 Corporate Ctr Ste 102
Granite City, IL 620404195
Phone: (618) 931-6980
Type: Location
4900 W Main St
Belleville, IL 622264725
Phone: (618) 235-2400
Type: Location
12 Professional Park Dr
Maryville, IL 620625672
Phone: (618) 288-7266
Type: Location
3990 N Illinois St
Swansea, IL 622261919
Phone: (618) 277-1130
Type: Location
7840 NATURAL BRIDGE RD # PCC
SAINT LOUIS, MO 631214617
Phone: (314) 516-5131
Fax: (314) 516-5507
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 54 Open Payments records for all available years, with a total value of $4,903.
Total Amount is formed as General ($4,903) + Research ($0) + Ownership ($0) = $4,903.
Last reported payment date: 2024-10-14 • Largest payer in this snapshot: Valley Contax, Inc. ($2,865).
Total Amount
$4,903
General + Research + Ownership
Payments
54
Total payment records
General Amount
$4,903
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Valley Contax, Inc. | $2,865 |
| Johnson & Johnson Vision Care, Inc. | $518 |
| Alcon Vision LLC | $518 |
| CooperVision Inc. | $492 |
| Tarsus Pharmaceuticals, Inc. | $143 |
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: 2024-08-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20230724000218 | I | Optometry | MO | TBD |
| I20240816001346 | I | Optometry | IL | 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 63108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | IL | |
| 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 | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P T O M E T R Y | IL |
Reviews
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