DR. KAREN T FORTMAN (O.D.) – Optometrist, NPI 1205898145
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,618 OPTOMETRY in OH
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Provider Addresses for DR. KAREN T FORTMAN (O.D.)
1086, Fairington Drive, Sidney, Shelby County, Ohio, 45365, United States
SIDNEY, OH 453658913
Phone: (937) 492-9197
Fax: (937) 492-1901
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 31 Open Payments records for all available years, with a total value of $2,228.
Total Amount is formed as General ($2,228) + Research ($0) + Ownership ($0) = $2,228.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Alcon Vision LLC ($1,158).
Total Amount
$2,228
General + Research + Ownership
Payments
31
Total payment records
General Amount
$2,228
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $1,158 |
| Bausch & Lomb Americas Inc. | $522 |
| CooperVision Inc. | $208 |
| Johnson & Johnson Vision Care, Inc. | $207 |
| Glaukos Corporation | $49 |
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: 2010-06-02
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 |
|---|---|---|---|---|
| I20100602000469 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 409 | 357 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 183 | 146 | $0 |
| 92250 | Photography of the retina | 168 | 161 | $0 |
| 92083 | Exam of visual field with extended testing | 123 | 95 | $0 |
| 92134 | Imaging of retina | 86 | 74 | $0 |
Insurance plans in this area (ZIP 45365)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | OH | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 19 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | OH | |
| - | OH | |
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | OH | |
| O P T O M E T R Y | OH |
Reviews
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