AMY MARIE NEIDEFFER – Optometrist, NPI 1114663291

AMY MARIE NEIDEFFER is a healthcare provider. based in Edmond, Oklahoma. specializing in OPTOMETRY. They hold a License No. 3189 (OK). The NPI Number for AMY MARIE NEIDEFFER is 1114663291

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
AMY MARIE NEIDEFFER
NPI
1114663291
Phone
Not provided
Address
14701 N SANTA FE AVE
Enumeration Date
11 May 2022
Last Update Date
14 August 2023

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
2084592641
Graduation Year
2022 (4 years ago)
PAC ID
0244688943
Group Practice PAC ID
6305038365
Professional Enrollment ID
I20240112001827
Address ID
ID836054826CA1702XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:4State licenses:2Digital endpointsOther names

684 OPTOMETRY in OK

Provider Addresses for AMY MARIE NEIDEFFER

  • 14701 N SANTA FE AVE

    EDMOND, OK 730133411

    Phone:

    Type: Mailing

  • 1702 S KIMBALL AVE

    CALDWELL, ID 836054826

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $508.

Total Amount is formed as General ($508) + Research ($0) + Ownership ($0) = $508.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($215).

Total Amount

$508

General + Research + Ownership

Payments

6

Total payment records

General Amount

$508

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

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: 2024-01-12

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
I20240112001827IOptometryIDTBD

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 73013)

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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: 6305038365View full group profile
NameSpecialtyState
O P T O M E T R YID

Reviews

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Frequently asked questions

How is AMY MARIE NEIDEFFER identified in CMS data?
CMS-hosted NPPES data lists AMY MARIE NEIDEFFER with NPI 1114663291.
Does CMS list AMY MARIE NEIDEFFER as active?
Yes — AMY MARIE NEIDEFFER is active in the NPI listing used on this page.
What taxonomy line describes AMY MARIE NEIDEFFER?
For research purposes, treat AMY MARIE NEIDEFFER as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for AMY MARIE NEIDEFFER?
AMY MARIE NEIDEFFER's geographic hint is Edmond, Oklahoma in our summary view.
Is the information about AMY MARIE NEIDEFFER up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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