JONATHAN LARSON (OD) – Optometrist, NPI 1912061458
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
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Provider Addresses for JONATHAN LARSON (OD)
West Avenue, The Bronx, Bronx County, New York, 10462, United States
SAN ANTONIO, TX 782131370
Phone: (210) 524-6663
Fax: (210) 524-6587
Type: Mailing
Golden Ticket Kandi 6, 1605, 1st Street South, Willmar, Kandiyohi County, Minnesota, 56201, United States
WILLMAR, MN 562014234
Phone: (320) 235-9060
Fax: (320) 235-9062
Type: Location
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: 2005-05-19
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 |
|---|---|---|---|---|
| I20050519000813 | I | Optometry | MN | 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 |
|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 2,160 | 14 | $0 |
| 92014 | Established patient complete exam of visual system | 278 | 277 | $0 |
| 92250 | Photography of the retina | 92 | 92 | $0 |
| 92134 | Imaging of retina | 75 | 72 | $0 |
| 92133 | Imaging of optic nerve | 33 | 29 | $0 |
Insurance plans in this area (ZIP 78213)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| O P T O M E T R Y | MN | |
| - | MN |
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