SAMUEL KIM (OD) – Optometrist, NPI 1174257703
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,771 OPTOMETRY in PA
Provider Addresses for SAMUEL KIM (OD)
1200 W GODFREY AVE
PHILADELPHIA, PA 191413323
Phone: (215) 276-6000
Fax: (215) 276-6096
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 15 Open Payments records for all available years, with a total value of $516.
Total Amount is formed as General ($516) + Research ($0) + Ownership ($0) = $516.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Oyster Point Pharma, Inc. ($176).
Total Amount
$516
General + Research + Ownership
Payments
15
Total payment records
General Amount
$516
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Oyster Point Pharma, Inc. | $176 |
| Harrow Eye, LLC | $124 |
| Bausch & Lomb Americas Inc. | $54 |
| Johnson & Johnson Vision Care, Inc. | $49 |
| Alcon Vision LLC | $47 |
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: 2022-07-25
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 |
|---|---|---|---|---|
| I20220725001448 | I | Optometry | PA | 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 | 39 | 39 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 21 | $0 |
| 92083 | Exam of visual field with extended testing | 16 | 15 | $0 |
| 92134 | Imaging of retina | 14 | 14 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 19141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | PA | |
| O P T O M E T R Y | PA | |
| - | PA | |
| O P T O M E T R Y | PA | |
| O P T O M E T R Y | PA | |
| O P T O M E T R Y | NY | |
| - | PA | |
| O P T O M E T R Y | PA | |
| O P T O M E T R Y | PA | |
| O P T O M E T R Y | PA |
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