DR. MARY LEE PEMBERTON (O.D.) – Optometrist, NPI 1003802422
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,052 OPTOMETRY in VA
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Provider Addresses for DR. MARY LEE PEMBERTON (O.D.)
Nationwide Insurance: John Burnett Insurance Agency, 2522, Jefferson Highway, Kingsbury Manor, Waynesboro, Augusta County, Virginia, 22980, United States
SUITE 106
WAYNESBORO, VA 229808503
Phone: (540) 946-8727
Fax: (540) 949-5526
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 8 Open Payments records for all available years, with a total value of $146.
Total Amount is formed as General ($146) + Research ($0) + Ownership ($0) = $146.
Last reported payment date: 2024-09-19 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($85).
Total Amount
$146
General + Research + Ownership
Payments
8
Total payment records
General Amount
$146
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2008-05-22
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 |
|---|---|---|---|---|
| I20080522000634 | I | Optometry | VA | 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 | 165 | 159 | $0 |
| 92012 | Established patient problem focused exam of visual system | 67 | 47 | $0 |
| 92004 | New patient complete exam of visual system | 40 | 40 | $0 |
| 92083 | Exam of visual field with extended testing | 37 | 28 | $0 |
| 92133 | Imaging of optic nerve | 37 | 28 | $0 |
Insurance plans in this area (ZIP 22980)
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Provider's Procedures
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