JACOB B VERGIN (O.D.) – Optometrist, NPI 1710185442
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
798 OPTOMETRY in WI
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Provider Addresses for JACOB B VERGIN (O.D.)
13151 39TH AVE N
CHIPPEWA FALLS, WI 547297144
Phone: (773) 297-5096
Type: Mailing
331, Prairie View Road, Chippewa Falls, Chippewa County, Wisconsin, 54729, United States
CHIPPEWA FALLS, WI 547293463
Phone: (715) 726-9077
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $167.
Total Amount is formed as General ($167) + Research ($0) + Ownership ($0) = $167.
Last reported payment date: 2024-05-08 • Largest payer in this snapshot: CooperVision Inc. ($99).
Total Amount
$167
General + Research + Ownership
Payments
6
Total payment records
General Amount
$167
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $99 |
| Alcon Vision LLC | $68 |
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: 2007-12-03
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 |
|---|---|---|---|---|
| I20071203000425 | I | Optometry | WI | 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 | 158 | 158 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 33 | 29 | $0 |
| 92004 | New patient complete exam of visual system | 32 | 32 | $0 |
| 92134 | Imaging of retina | 31 | 28 | $0 |
Insurance plans in this area (ZIP 54729)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | WI | 92134 | Diagnostic imaging of retina | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | WI | |
| O P T O M E T R Y | WI | |
| O P T O M E T R Y | WI |
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