IVAN RUSSELL WHETTEN (O.D.) – Optometrist, NPI 1780069401

IVAN RUSSELL WHETTEN (O.D.) is a healthcare provider. based in Rock springs, Wyoming. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 400T (WY). The NPI Number for IVAN RUSSELL WHETTEN (O.D.) is 1780069401

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
IVAN RUSSELL WHETTEN (O.D.)
NPI
1780069401
Phone
(307) 382-3753
Address
2624 COMMERICAL WAY STE B
Enumeration Date
23 July 2015
Last Update Date
11 August 2015

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
8017681900
Graduation Year
2015 (11 years ago)
PAC ID
5092022392
Group Practice PAC ID
8426079690
Professional Enrollment ID
I20190205002400
Address ID
UT840454032SA1528XDRXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

106 OPTOMETRY in WY

Provider Addresses for IVAN RUSSELL WHETTEN (O.D.)

  • 2624 COMMERICAL WAY STE B

    ROCK SPRINGS, WY 829014769

    Phone: (307) 382-3753

    Type: Mailing

  • 2624 COMMERCIAL WAY

    STE B

    ROCK SPRINGS, WY 829014769

    Phone: (307) 382-3753

    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: 2024-10-02 • Largest payer in this snapshot: CooperVision Inc. ($46).

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

2024-10-02

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-02-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190205002400IOptometryUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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 82901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426079690View full group profile
NameSpecialtyState
O P T O M E T R YUT
-TX
O P T O M E T R YUT
O P T O M E T R YUT

Reviews

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Frequently asked questions

Can I cross-check IVAN RUSSELL WHETTEN (O.D.) using NPI 1780069401?
NPI 1780069401 belongs to IVAN RUSSELL WHETTEN (O.D.); compare other details if you need extra assurance.
Is IVAN RUSSELL WHETTEN (O.D.) shown as active in public data?
Registry records indicate IVAN RUSSELL WHETTEN (O.D.) maintains an active NPI.
How would a patient describe IVAN RUSSELL WHETTEN (O.D.)'s focus?
For IVAN RUSSELL WHETTEN (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is IVAN RUSSELL WHETTEN (O.D.) located near Rock Springs?
IVAN RUSSELL WHETTEN (O.D.) currently maps to Rock Springs, Wyoming in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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