EDWARD R NICHOLLS (O.D.) – Optometrist, NPI 1376981175
Optometrist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
312 OPTOMETRY in UT
Provider Addresses for EDWARD R NICHOLLS (O.D.)
323 W STATE RD STE A
AMERICAN FORK, UT 840035600
Phone: (801) 763-9898
Fax: (801) 763-7217
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 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-02-08 • Largest payer in this snapshot: CooperVision Inc. ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $18 |
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: 2014-02-04
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 |
|---|---|---|---|---|
| I20140204001847 | I | Optometry | UT | 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 | 76 | 75 | $0 |
| 92004 | New patient complete exam of visual system | 50 | 50 | $0 |
| 92250 | Photography of the retina | 44 | 44 | $0 |
Insurance plans in this area (ZIP 84003)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Emergency Medicine | CO | |
| - | UT | |
| A N E S T H E S I O L O G Y | UT | |
| Physician Assistant | UT | |
| - | IL | |
| Plastic And Reconstructive Surgery | OH | |
| Physician Assistant | CA | |
| A N E S T H E S I O L O G Y | UT |
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