JERAD CROSWELL (OD) – Optometrist, NPI 1619603297

JERAD CROSWELL (OD) is a healthcare provider. based in Pendleton, Oregon. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. ATI4639 (OR). The NPI Number for JERAD CROSWELL (OD) is 1619603297

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
JERAD CROSWELL (OD)
NPI
1619603297
Phone
(541) 966-9830
Address
46314 TIMINE WAY
Enumeration Date
27 July 2022
Last Update Date
27 July 2022

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
5419669830
Graduation Year
2022 (4 years ago)
PAC ID
1153705942
Group Practice PAC ID
6608924121
Professional Enrollment ID
I20220828000058
Address ID
OR978019417PE46314WAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

672 OPTOMETRY in OR

Provider Addresses for JERAD CROSWELL (OD)

  • 46314 TIMINE WAY

    PENDLETON, OR 978019417

    Phone: (541) 966-9830

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-08-28

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
I20220828000058IOptometryTXTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes5045$0
92250Photography of the retina3532$0
92134Imaging of retina1513$0
92133Imaging of optic nerve1311$0
92083Exam of visual field with extended testing1111$0
View full utilization report →

Insurance plans in this area (ZIP 97801)

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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: 6608924121View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA
Physician AssistantOR
Physical Therapist In Private PracticeNV
Registered Dietitian Or Nutrition ProfessionalOR
Nurse PractitionerWA
-OR
Clinical Social WorkerOR
-OR
P O D I A T R YOH
Family PracticeOR

Reviews

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Frequently asked questions

How is JERAD CROSWELL (OD) identified in CMS data?
CMS-hosted NPPES data lists JERAD CROSWELL (OD) with NPI 1619603297.
Is JERAD CROSWELL (OD) listed as active for patients and plans?
The listing shows JERAD CROSWELL (OD) as active in the NPI system.
What is JERAD CROSWELL (OD)'s specialty?
The listing groups JERAD CROSWELL (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
Does JERAD CROSWELL (OD) list a practice location?
Patients near Pendleton, Oregon may find JERAD CROSWELL (OD) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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