RUSSELL S. FILLMORE (OD) – Optometrist, NPI 1306860754

RUSSELL S. FILLMORE (OD) is a healthcare provider. based in Mansfield, Ohio. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. 4193T1387 (OH). The NPI Number for RUSSELL S. FILLMORE (OD) is 1306860754

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
RUSSELL S. FILLMORE (OD)
NPI
1306860754
Phone
(419) 756-0500
Address
1164 LEXINGTON AVE
Enumeration Date
27 July 2006
Last Update Date
30 June 2017

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
4197560500
Graduation Year
1990 (36 years ago)
PAC ID
7618925116
Group Practice PAC ID
0749504165
Professional Enrollment ID
I20050112000225
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for RUSSELL S. FILLMORE (OD)

  • 1164, Lexington Avenue, South Boulevards, Mansfield, Richland County, Ohio, 44907, United States

    MANSFIELD, OH 449072254

    Phone: (419) 756-0500

    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 5 Open Payments records for all available years, with a total value of $316.

Total Amount is formed as General ($316) + Research ($0) + Ownership ($0) = $316.

Last reported payment date: 2024-05-16 • Largest payer in this snapshot: Harrow Eye, LLC ($115).

Total Amount

$316

General + Research + Ownership

Payments

5

Total payment records

General Amount

$316

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-16

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: 2005-01-12

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
I20050112000225IOptometryOHTBD

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
92014Established patient complete exam of visual system5050$0
92012Established patient problem focused exam of visual system2720$0
92250Photography of the retina1918$0
92004New patient complete exam of visual system1212$0
View full utilization report →

Insurance plans in this area (ZIP 44907)

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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: 0749504165View full group profile

Reviews

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Frequently asked questions

Can I cross-check RUSSELL S. FILLMORE (OD) using NPI 1306860754?
NPI 1306860754 belongs to RUSSELL S. FILLMORE (OD); compare other details if you need extra assurance.
Is RUSSELL S. FILLMORE (OD) still an active registrant?
RUSSELL S. FILLMORE (OD) carries an active NPI according to the public dataset.
What clinical focus is listed for RUSSELL S. FILLMORE (OD)?
At a glance, RUSSELL S. FILLMORE (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is RUSSELL S. FILLMORE (OD) located near Mansfield?
RUSSELL S. FILLMORE (OD) currently maps to Mansfield, Ohio in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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