SAMUEL PASSI (M.D.) – Ophthalmology Physician, NPI 1609250497
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
214 OPHTHALMOLOGY in UT
Provider Addresses for SAMUEL PASSI (M.D.)
755 E 3900 S
SALT LAKE CITY, UT 841072176
Phone: (801) 263-5757
Fax: (801) 263-5758
Type: Mailing
101 E Wood St
Spartanburg, SC 293033040
Phone: (864) 560-6000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $721.
Total Amount is formed as General ($721) + Research ($0) + Ownership ($0) = $721.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Alcon Vision LLC ($286).
Total Amount
$721
General + Research + Ownership
Payments
24
Total payment records
General Amount
$721
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $286 |
| Rayner Intraocular Lenses Limited | $154 |
| ABBVIE INC. | $91 |
| BIOTISSUE HOLDINGS INC. | $56 |
| Bausch & Lomb Americas Inc. | $39 |
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: 2020-05-28
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 |
|---|---|---|---|---|
| I20200528003065 | I | Ophthalmology | 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 |
|---|---|---|---|---|
| 92136 | Measurement of corneal curvature and depth of eye | 214 | 140 | $0 |
| 66984 | Removal of cataract with insertion of prosthetic lens | 180 | 107 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 111 | 81 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 108 | 108 | $0 |
| 92134 | Imaging of retina | 104 | 102 | $0 |
Insurance plans in this area (ZIP 84107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | UT | |
| - | UT | |
| O P T O M E T R Y | UT | |
| - | UT | |
| O P H T H A L M O L O G Y | UT | |
| - | UT | |
| O P H T H A L M O L O G Y | UT | |
| O P T O M E T R Y | UT | |
| O P H T H A L M O L O G Y | UT | |
| - | UT |
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