RICHARD ALLEN STATESIR (M.D.) – Ophthalmology Physician, NPI 1699778142
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
841 OPHTHALMOLOGY in OH
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Provider Addresses for RICHARD ALLEN STATESIR (M.D.)
14701 DETROIT AVE STE 280
LAKEWOOD, OH 441074109
Phone: (216) 228-9122
Fax: (216) 221-9773
Type: Mailing
Sauced Taproom, 14701, Detroit Avenue, Lakewood, Cuyahoga County, Ohio, 44107, United States
STE 280
LAKEWOOD, OH 441074109
Phone: (216) 228-9122
Fax: (216) 221-9773
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2012-01-31
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 |
|---|---|---|---|---|
| I20120131000950 | I | Ophthalmology | 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 | 324 | 313 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 158 | 69 | $0 |
| 92250 | Photography of the retina | 68 | 68 | $0 |
| 92083 | Exam of visual field with extended testing | 41 | 39 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 26 | 26 | $0 |
Insurance plans in this area (ZIP 44107)
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Provider's Procedures
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