MICHAEL S PETERSON (O.D.) – Optometrist, NPI 1528020955
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
312 OPTOMETRY in UT
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Provider Addresses for MICHAEL S PETERSON (O.D.)
Port of Subs, 177 West, 12300 South, Riverton Siding, Draper, Salt Lake County, Utah, 84020, United States
STE 111
DRAPER, UT 840209816
Phone: (801) 679-9177
Fax: (801) 878-7674
Type: Mailing
Villa Vista Avenue, Sugar House, Millcreek, Salt Lake County, Utah, 84106, United States
SALT LAKE CITY, UT 841063419
Phone: (801) 879-8721
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $346.
Total Amount is formed as General ($346) + Research ($0) + Ownership ($0) = $346.
Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Alcon Vision LLC ($286).
Total Amount
$346
General + Research + Ownership
Payments
17
Total payment records
General Amount
$346
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $286 |
| CooperVision Inc. | $60 |
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: 2009-06-12
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 |
|---|---|---|---|---|
| I20090612000171 | 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 |
|---|---|---|---|---|
| 92250 | Photography of the retina | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84020)
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