DR. KENNETH DAVID BOLTZ (O.D.) – Optometrist, NPI 1699767632
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. KENNETH DAVID BOLTZ (O.D.)
5775, Perimeter Drive, Dublin, Ohio, 43017, United States
STE 160
DUBLIN, OH 430173257
Phone: (614) 763-5775
Fax: (614) 675-3338
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 21 Open Payments records for all available years, with a total value of $1,573.
Total Amount is formed as General ($1,573) + Research ($0) + Ownership ($0) = $1,573.
Last reported payment date: 2024-06-05 • Largest payer in this snapshot: CooperVision Inc. ($533).
Total Amount
$1,573
General + Research + Ownership
Payments
21
Total payment records
General Amount
$1,573
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $533 |
| Optos, Inc. | $317 |
| Alcon Vision LLC | $245 |
| TOPCON MEDICAL SYSTEMS, INC. | $228 |
| BIOTISSUE HOLDINGS, INC. | $168 |
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: 2010-09-03
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 |
|---|---|---|---|---|
| I20100903000796 | 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 | 130 | 123 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 54 | 40 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 43017)
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