CLARISSA NICOLE BURNS (OD) – Optometrist, NPI 1639941099

CLARISSA NICOLE BURNS (OD) is a healthcare provider. based in Dayton, Ohio. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT.007223 (OH). The NPI Number for CLARISSA NICOLE BURNS (OD) is 1639941099

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
CLARISSA NICOLE BURNS (OD)
NPI
1639941099
Phone
(937) 320-0300
Address
4244 INDIANA RIPPLE ROAD
Enumeration Date
27 October 2023
Last Update Date
23 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9373200300
Graduation Year
2021 (5 years ago)
PAC ID
5799121174
Group Practice PAC ID
1052397809
Professional Enrollment ID
I20240307001902
Address ID
OH454403248BE4244XRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:2State licenses:2Digital endpointsOther names

1,618 OPTOMETRY in OH

Provider Addresses for CLARISSA NICOLE BURNS (OD)

  • 4244 INDIANA RIPPLE ROAD

    SUITE 100

    DAYTON, OH 45440

    Phone: (937) 320-0300

    Fax: (937) 320-0500

    Type: Mailing

  • 4244 INDIANA RIPPLE RD

    SUITE 100

    BEAVERCREEK, OH 45440

    Phone: (937) 320-0300

    Fax: (937) 320-0500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-03-07

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
I20240307001902IOptometryOHTBD

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 45440)

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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: 1052397809View full group profile

Reviews

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Frequently asked questions

Where can patients find CLARISSA NICOLE BURNS (OD)'s NPI?
You can confirm CLARISSA NICOLE BURNS (OD) with NPI 1639941099; it appears in the national provider directory.
Does this profile mean CLARISSA NICOLE BURNS (OD) is currently active?
Yes — CLARISSA NICOLE BURNS (OD) appears active in the national provider directory.
What field does CLARISSA NICOLE BURNS (OD) work in?
You can think of CLARISSA NICOLE BURNS (OD) as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Does CLARISSA NICOLE BURNS (OD) practice in Ohio?
You will see Dayton, Ohio on file for CLARISSA NICOLE BURNS (OD) alongside any extra practice locations.
Is CLARISSA NICOLE BURNS (OD) a real provider?
This page reflects official NPPES data for NPI 1639941099. Always confirm identity and privileges with the practice and licensing boards.