JACOB MITTELSTAEDT (OD) – Optometrist, NPI 1861062176
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
851 OPTOMETRY in CO
Provider Addresses for JACOB MITTELSTAEDT (OD)
1950 OLD GALLOWS RD STE 520
VIENNA, VA 221823970
Phone: (703) 847-8899
Fax: (571) 223-6780
Type: Mailing
2867 35TH AVE
GREELEY, CO 806349407
Phone: (970) 346-1411
Type: Location
8614 WESTWOOD CENTER DR FL 9
VIENNA, VA 221822442
Phone: (703) 847-8899
Fax: (571) 223-6780
Type: Mailing
119 PATTERSON RD
HAINES CITY, FL 338447803
Phone: (863) 421-2700
Fax: (863) 421-7629
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $73.
Total Amount is formed as General ($73) + Research ($0) + Ownership ($0) = $73.
Last reported payment date: 2024-05-20 • Largest payer in this snapshot: CooperVision Inc. ($28).
Total Amount
$73
General + Research + Ownership
Payments
4
Total payment records
General Amount
$73
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $28 |
| Bausch & Lomb Americas Inc. | $25 |
| Oyster Point Pharma, Inc. | $20 |
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: 2023-03-24
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 |
|---|---|---|---|---|
| I20230324001286 | I | Optometry | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 22182)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL | |
| O P T O M E T R Y | FL |
Reviews
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