JEFFREY S TACK (OD) – Optometrist, NPI 1710046610
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,098 OPTOMETRY in WA
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Provider Addresses for JEFFREY S TACK (OD)
820, Ocean Beach Highway, Columbia Valley Gardens, Longview, Cowlitz County, Washington, 98632, United States
SUITE 100
LONGVIEW, WA 986324080
Phone: (360) 636-2020
Fax: (360) 425-0221
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 7 Open Payments records for all available years, with a total value of $194.
Total Amount is formed as General ($194) + Research ($0) + Ownership ($0) = $194.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: CooperVision Inc. ($125).
Total Amount
$194
General + Research + Ownership
Payments
7
Total payment records
General Amount
$194
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $125 |
| Alcon Vision LLC | $69 |
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: 2004-07-01
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 |
|---|---|---|---|---|
| I20040701000323 | I | Optometry | WA | 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 | 397 | 377 | $0 |
| 92014 | Established patient complete exam of visual system | 219 | 219 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 204 | 120 | $0 |
| 92083 | Exam of visual field with extended testing | 51 | 45 | $0 |
| 92133 | Imaging of optic nerve | 36 | 34 | $0 |
Insurance plans in this area (ZIP 98632)
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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 | 38 | 32 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA |
Reviews
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