ELIZABETH A POTVIN (OD) – Optometrist, NPI 1063568152

ELIZABETH A POTVIN (OD) is a healthcare provider. based in Bend, Oregon. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 4901004355 (MI). The NPI Number for ELIZABETH A POTVIN (OD) is 1063568152

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH A POTVIN (OD)
NPI
1063568152
Phone
(541) 318-8388
Address
2450 NE MARY ROSE PL
Enumeration Date
25 January 2007
Last Update Date
7 October 2024

Doctor Profile

Medical School Name
INTERNATIONAL AMERICAN UNIVERSITY AT PUERTO RICO - SCHOOL OF OPTOMETRY
Secondary Phone
5413188388
Graduation Year
2004 (22 years ago)
PAC ID
7315099827
Group Practice PAC ID
2365436755
Professional Enrollment ID
I20130920000631
Address ID
OR977017132BE2450XPLXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

672 OPTOMETRY in OR

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Provider Addresses for ELIZABETH A POTVIN (OD)

  • Northeast Mary Rose Place, Bend, Deschutes County, Oregon, 97701, United States

    SUITE 110

    BEND, OR 977017132

    Phone: (541) 318-8388

    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 29 Open Payments records for all available years, with a total value of $734.

Total Amount is formed as General ($734) + Research ($0) + Ownership ($0) = $734.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Sun Pharmaceutical Industries Inc. ($169).

Total Amount

$734

General + Research + Ownership

Payments

29

Total payment records

General Amount

$734

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

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: 2013-09-20

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
I20130920000631IOptometryORTBD

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 system309301$0
92012Established patient problem focused exam of visual system213167$0
92134Imaging of retina145139$0
99214Established patient office or other outpatient visit, 30-39 minutes144143$0
92133Imaging of optic nerve126120$0
View full utilization report →

Insurance plans in this area (ZIP 97701)

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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: 2365436755View full group profile
NameSpecialtyState
O P T O M E T R YOR
O P T O M E T R YOR
O P H T H A L M O L O G YTX
O P H T H A L M O L O G YOR
-OR
O P T O M E T R YOR
O P H T H A L M O L O G YOR

Reviews

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Frequently asked questions

What number should I use to identify ELIZABETH A POTVIN (OD) for billing?
Administrative and clinical systems typically use NPI 1063568152 for ELIZABETH A POTVIN (OD).
Is ELIZABETH A POTVIN (OD) currently accepting referrals based on NPI status?
Registry metadata lists ELIZABETH A POTVIN (OD) as active.
What type of care does ELIZABETH A POTVIN (OD) provide?
ELIZABETH A POTVIN (OD)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
Which community is linked to ELIZABETH A POTVIN (OD)?
ELIZABETH A POTVIN (OD) shows a connection to Bend, Oregon in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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