Kodiak Vision Clinic – Optometrist, NPI 1487245676
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Kodiak Vision Clinic
214 W REZANOF DR
KODIAK, AK 996156044
Phone: (717) 307-5761
Type: Mailing
800 Glacier Ave Ste 203
Juneau, AK 998011852
Phone: (907) 586-9864
Fax: (833) 296-5244
Type: Location
10928 Eagle River Rd Ste 102
Eagle River, AK 995778078
Phone: (907) 694-2020
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2021-02-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation scheduled
Earliest CMS due date is 2026-10-31 (145 days away).
Enrollment records
1
Earliest due date
2026-10-31
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 |
|---|---|---|---|---|
| O20210223001841 | O | Clinic/Group Practice | AK | 2026-10-31 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
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 99615)
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