DR. MICHAEL D VAN BROCKLIN (OD) – Optometrist, NPI 1417992900
Optometrist
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,098 OPTOMETRY in WA
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Provider Addresses for DR. MICHAEL D VAN BROCKLIN (OD)
2915, South Alder Street, Tacoma, Pierce County, Washington, 98409, United States
TACOMA, WA 984094803
Phone: (253) 473-0275
Fax: (253) 473-0706
Type: Location
Chehalis Post Office, Northwest Center Street, Chehalis, Lewis County, Washington, United States
CHEHALIS, WA 985320409
Phone: (360) 242-3008
Fax: (360) 807-7687
Type: Mailing
4330 MITCHELL WAY
BELLINGHAM, WA 982269175
Phone: (360) 738-6860
Fax: (360) 738-6853
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $56.
Total Amount is formed as General ($56) + Research ($0) + Ownership ($0) = $56.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Rayner Intraocular Lenses Limited ($22).
Total Amount
$56
General + Research + Ownership
Payments
3
Total payment records
General Amount
$56
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Rayner Intraocular Lenses Limited | $22 |
| RxSight Inc | $17 |
| ABBVIE INC. | $17 |
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: 2008-10-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040506001338 | I | Optometry | WA | TBD |
| I20081001000209 | I | Optometry | AK | 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 |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 119 | 119 | $0 |
| 92136 | Measurement of corneal curvature and depth of eye | 62 | 62 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 50 | 45 | $0 |
| 92134 | Imaging of retina | 26 | 26 | $0 |
Insurance plans in this area (ZIP 98409)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | WA | 92083 | Measurement of field of vision during daylight conditions | 35 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| - | WA | |
| O P H T H A L M O L O G Y | WA | |
| O P H T H A L M O L O G Y | WA | |
| O P T O M E T R Y | WA | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | OR | |
| O P H T H A L M O L O G Y | WA |
Reviews
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