DR. SAMANTHA ANN BLANKE (OD) – Optometrist, NPI 1245929140
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
672 OPTOMETRY in OR
Provider Addresses for DR. SAMANTHA ANN BLANKE (OD)
15259 SE 82nd Dr Ste 101
Clackamas, OR 970156609
Phone: (920) 905-2836
Type: Location
1114 Fashion Ridge Rd # Vision1
Dry Ridge, KY 410359609
Phone: (859) 824-4415
Type: Location
3405 WOODLAND DR
MANITOWOC, WI 542209664
Phone: (920) 905-2836
Type: Mailing
2174 DIXIE HWY
FT MITCHELL, KY 410172972
Phone: (859) 341-2566
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $271.
Total Amount is formed as General ($271) + Research ($0) + Ownership ($0) = $271.
Last reported payment date: 2024-08-27 • Largest payer in this snapshot: Carl Zeiss Meditec, Inc. ($121).
Total Amount
$271
General + Research + Ownership
Payments
4
Total payment records
General Amount
$271
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Carl Zeiss Meditec, Inc. | $121 |
| Bausch & Lomb Americas Inc. | $118 |
| CooperVision Inc. | $33 |
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: 2024-09-03
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 |
|---|---|---|---|---|
| I20240903001463 | I | Optometry | KY | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | KY | |
| - | KY | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | KY |
Reviews
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