KATHLEEN SIMMS RUDOLF (O. D.) – Optometrist, NPI 1033349055
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,618 OPTOMETRY in OH
Provider Addresses for KATHLEEN SIMMS RUDOLF (O. D.)
2850 CENTRE DR STE 6A
BEAVERCREEK, OH 453248611
Phone: (937) 294-4060
Fax: (937) 306-5245
Type: Mailing
813, Troy Street, Kossuth Colony Historic District, Dayton, Montgomery County, Ohio, 45404, United States
DAYTON, OH 454041852
Phone: (937) 228-2020
Fax: (937) 228-8769
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $1,089.
Total Amount is formed as General ($1,089) + Research ($0) + Ownership ($0) = $1,089.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($649).
Total Amount
$1,089
General + Research + Ownership
Payments
21
Total payment records
General Amount
$1,089
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Johnson & Johnson Vision Care, Inc. | $649 |
| CooperVision Inc. | $141 |
| BIOTISSUE HOLDINGS, INC. | $124 |
| BIOTISSUE HOLDINGS INC. | $103 |
| Tarsus Pharmaceuticals, Inc. | $57 |
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: 2009-09-30
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 |
|---|---|---|---|---|
| I20090930000261 | I | Optometry | OH | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 44 | 44 | $0 |
| 92133 | Imaging of optic nerve | 19 | 15 | $0 |
| 92004 | New patient complete exam of visual system | 19 | 19 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15 | 14 | $0 |
Insurance plans in this area (ZIP 45324)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | AL | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | AL | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | CT |
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