SAMUEL ADAM PHELPS (O.D.) – Optometrist, NPI 1164651998
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
957 OPTOMETRY in TN
Provider Addresses for SAMUEL ADAM PHELPS (O.D.)
668 Skyline Dr
Jackson, TN 383013951
Phone: (731) 424-2414
Type: Location
1340 Union University Dr
Jackson, TN 383053780
Phone: (731) 424-2414
Type: Location
668 SKYLINE DR
JACKSON, TN 383013951
Phone: (731) 424-2414
Type: Mailing
138 S WASHINGTON AVE
HENDERSON, TN 383402323
Phone: (731) 989-3511
Type: Location
Virginia Eye Clinic, 2413, Wards Road, Sheffield, Lynchburg, Virginia, 24502, United States
LYNCHBURG, VA 245022103
Phone: (434) 239-5323
Fax: (434) 239-1388
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $605.
Total Amount is formed as General ($605) + Research ($0) + Ownership ($0) = $605.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: ABBVIE INC. ($247).
Total Amount
$605
General + Research + Ownership
Payments
7
Total payment records
General Amount
$605
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $247 |
| Dompe US, Inc. | $125 |
| Apellis Pharmaceuticals, Inc. | $111 |
| Alcon Vision LLC | $77 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $23 |
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: 2010-11-09
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 |
|---|---|---|---|---|
| I20101109000481 | I | Optometry | TN | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 236 | 228 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 209 | 161 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 104 | 91 | $0 |
| 92133 | Imaging of optic nerve | 98 | 77 | $0 |
| 92004 | New patient complete exam of visual system | 80 | 80 | $0 |
Insurance plans in this area (ZIP 38301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | TN | |
| O P T O M E T R Y | TN | |
| - | TN | |
| O P H T H A L M O L O G Y | TN | |
| O P T O M E T R Y | TN | |
| - | TN | |
| O P H T H A L M O L O G Y | TN | |
| O P H T H A L M O L O G Y | AR | |
| O P H T H A L M O L O G Y | TN |
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