PAIGE BENTEN DIEPENBROCK (OD) – Optometrist, NPI 1962070235

PAIGE BENTEN DIEPENBROCK (OD) is a healthcare provider. based in Saint louis, Missouri. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2021020950 (MO). The NPI Number for PAIGE BENTEN DIEPENBROCK (OD) is 1962070235

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
PAIGE BENTEN DIEPENBROCK (OD)
NPI
1962070235
Phone
(314) 843-2020
Address
17 RONNIES PLZ
Enumeration Date
14 June 2021
Last Update Date
10 May 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
3148432020
Graduation Year
2021 (5 years ago)
PAC ID
1153722681
Group Practice PAC ID
3072859156
Professional Enrollment ID
I20210622001768
Address ID
MO631263552SA17XXXPLZX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for PAIGE BENTEN DIEPENBROCK (OD)

  • 17 RONNIES PLZ

    SAINT LOUIS, MO 631263552

    Phone: (314) 843-2020

    Fax: (314) 843-2021

    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 15 Open Payments records for all available years, with a total value of $590.

Total Amount is formed as General ($590) + Research ($0) + Ownership ($0) = $590.

Last reported payment date: 2024-09-25 • Largest payer in this snapshot: LKC Technologies, Inc. ($169).

Total Amount

$590

General + Research + Ownership

Payments

15

Total payment records

General Amount

$590

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-25

Latest reported date

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: 2021-06-22

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
I20210622001768IOptometryMOTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes5949$0
99214Established patient office or other outpatient visit, 30-39 minutes2622$0
92250Photography of the retina2424$0
92134Imaging of retina1815$0
View full utilization report →

Insurance plans in this area (ZIP 63126)

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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: 3072859156View full group profile
NameSpecialtyState
O P T O M E T R YMO

Reviews

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Frequently asked questions

What unique ID ties claims to PAIGE BENTEN DIEPENBROCK (OD)?
NPI 1962070235 is assigned to PAIGE BENTEN DIEPENBROCK (OD) under the national enumeration system.
Is PAIGE BENTEN DIEPENBROCK (OD)'s NPI currently valid?
The extract we use shows PAIGE BENTEN DIEPENBROCK (OD) as active.
Does PAIGE BENTEN DIEPENBROCK (OD) list a primary specialty?
If you are matching referrals, note Optometrist for PAIGE BENTEN DIEPENBROCK (OD). Clinical services aligned with this taxonomy classification.
What location shows for PAIGE BENTEN DIEPENBROCK (OD)?
We surface Saint Louis, Missouri for PAIGE BENTEN DIEPENBROCK (OD) based on available NPPES addresses.
Is PAIGE BENTEN DIEPENBROCK (OD) a real provider?
This page reflects official NPPES data for NPI 1962070235. Always confirm identity and privileges with the practice and licensing boards.

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