SPENCER ALLEN ROBERTSON (OD) – Optometrist, NPI 1003675489

SPENCER ALLEN ROBERTSON (OD) is a healthcare provider. based in Fallon, Nevada. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 1195 (NV). The NPI Number for SPENCER ALLEN ROBERTSON (OD) is 1003675489

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
SPENCER ALLEN ROBERTSON (OD)
NPI
1003675489
Phone
(775) 427-6774
Address
4989 RIVERS EDGE DR
Enumeration Date
18 March 2024
Last Update Date
19 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7755751966
Graduation Year
2024 (2 years ago)
PAC ID
4981141686
Group Practice PAC ID
5193616480
Professional Enrollment ID
I20240730004186
Address ID
NV894087741FE198XXSTXX400
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

386 OPTOMETRY in NV

Provider Addresses for SPENCER ALLEN ROBERTSON (OD)

  • 4989 RIVERS EDGE DR

    FALLON, NV 894061202

    Phone: (775) 427-6774

    Type: Mailing

  • 65 N TAYLOR ST

    FALLON, NV 894062750

    Phone: (775) 423-8024

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Alcon Vision LLC ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alcon Vision LLC$25
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: 2024-12-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240730004186IOptometryNVTBD
I20241218000704IOptometryTXTBD

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 89406)

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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: 5193616480View full group profile
NameSpecialtyState
O P T O M E T R YNV
O P T O M E T R YNV

Reviews

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Frequently asked questions

Where can patients find SPENCER ALLEN ROBERTSON (OD)'s NPI?
You can confirm SPENCER ALLEN ROBERTSON (OD) with NPI 1003675489; it appears in the national provider directory.
Is SPENCER ALLEN ROBERTSON (OD) currently active in the NPI registry?
CMS-published data lists SPENCER ALLEN ROBERTSON (OD) as an active registrant.
Does SPENCER ALLEN ROBERTSON (OD) list a primary specialty?
If you are matching referrals, note Optometrist for SPENCER ALLEN ROBERTSON (OD). Clinical services aligned with this taxonomy classification.
Where does public data place SPENCER ALLEN ROBERTSON (OD)?
The snapshot lists Fallon, Nevada for SPENCER ALLEN ROBERTSON (OD); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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