DR. BENJAMIN D KLIBANOFF (OD) – Optometrist, NPI 1053611996

DR. BENJAMIN D KLIBANOFF (OD) is a healthcare provider. based in Pawtucket, Rhode Island. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. CODTG00551 (RI). The NPI Number for DR. BENJAMIN D KLIBANOFF (OD) is 1053611996

Main info

Male
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. BENJAMIN D KLIBANOFF (OD)
NPI
1053611996
Phone
(401) 723-3400
Address
55 BROAD ST
Enumeration Date
26 October 2010
Last Update Date
12 April 2016

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
4017233400
Graduation Year
2010 (16 years ago)
PAC ID
0446422232
Group Practice PAC ID
6002993045
Professional Enrollment ID
I20111021000255
Address ID
RI028602023PA55XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:15State licenses:2Digital endpointsOther names

225 OPTOMETRY in RI

Provider Addresses for DR. BENJAMIN D KLIBANOFF (OD)

  • 55 BROAD ST

    PAWTUCKET, RI 028602023

    Phone: (401) 723-3400

    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 2 Open Payments records for all available years, with a total value of $32.

Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.

Last reported payment date: 2023-10-18 • Largest payer in this snapshot: Horizon Therapeutics plc ($16).

Total Amount

$32

General + Research + Ownership

Payments

2

Total payment records

General Amount

$32

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-18

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: 2011-10-21

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
I20111021000255IOptometryRITBD

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 system5554$0
92250Photography of the retina5250$0
99213Established patient office or other outpatient visit, 20-29 minutes4938$0
92012Established patient problem focused exam of visual system4026$0
92004New patient complete exam of visual system3434$0
View full utilization report →

Insurance plans in this area (ZIP 02860)

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Provider's Procedures

DR. BENJAMIN D KLIBANOFF (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYRI92012Eye and medical examination for diagnosis and treatment, established patient3723

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: 6002993045View full group profile
NameSpecialtyState
-RI
O P T O M E T R YRI

Reviews

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Frequently asked questions

How do payers reference DR. BENJAMIN D KLIBANOFF (OD)?
For DR. BENJAMIN D KLIBANOFF (OD), use NPI 1053611996 as the unique 10-digit identifier.
Active or inactive — what applies to DR. BENJAMIN D KLIBANOFF (OD)?
You should see DR. BENJAMIN D KLIBANOFF (OD) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. BENJAMIN D KLIBANOFF (OD)?
At a glance, DR. BENJAMIN D KLIBANOFF (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. BENJAMIN D KLIBANOFF (OD) located near Pawtucket?
DR. BENJAMIN D KLIBANOFF (OD) currently maps to Pawtucket, Rhode Island in this extract.
Can I trust this NPI listing for DR. BENJAMIN D KLIBANOFF (OD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.