ETHAN ROCKWELL (OD) – Optometrist, NPI 1417639022

ETHAN ROCKWELL (OD) is a healthcare provider. based in Norfolk, Nebraska. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 1625 (NE). The NPI Number for ETHAN ROCKWELL (OD) is 1417639022

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
ETHAN ROCKWELL (OD)
NPI
1417639022
Phone
(515) 865-3575
Address
1201 TARA HEIGHTS DR
Enumeration Date
3 August 2023
Last Update Date
3 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4023718230
Graduation Year
2023 (3 years ago)
PAC ID
3476916511
Group Practice PAC ID
0648602284
Professional Enrollment ID
I20230823000386
Address ID
NE687017702NO3610XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

338 OPTOMETRY in NE

Provider Addresses for ETHAN ROCKWELL (OD)

  • 1201 TARA HEIGHTS DR

    NORFOLK, NE 687013090

    Phone: (515) 865-3575

    Type: Mailing

  • 3610 W NORFOLK AVE

    NORFOLK, NE 687017702

    Phone: (402) 371-8230

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $72.

Total Amount is formed as General ($72) + Research ($0) + Ownership ($0) = $72.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($58).

Total Amount

$72

General + Research + Ownership

Payments

3

Total payment records

General Amount

$72

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

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: 2023-08-23

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
I20230823000386IOptometryNETBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68701)

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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: 0648602284View full group profile
NameSpecialtyState
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE
O P T O M E T R YNE

Reviews

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Frequently asked questions

Can I cross-check ETHAN ROCKWELL (OD) using NPI 1417639022?
NPI 1417639022 belongs to ETHAN ROCKWELL (OD); compare other details if you need extra assurance.
Is ETHAN ROCKWELL (OD) still an active registrant?
ETHAN ROCKWELL (OD) carries an active NPI according to the public dataset.
What area of care is associated with ETHAN ROCKWELL (OD)?
ETHAN ROCKWELL (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Is ETHAN ROCKWELL (OD) associated with Norfolk?
Public fields place ETHAN ROCKWELL (OD) around Norfolk, Nebraska. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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