Unknown Individual – Optometrist, NPI 1205817392
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
763, Southwest Main Boulevard, Lake City, Columbia County, Florida, 32025, United States
LAKE CITY, FL 320255791
Phone: (386) 752-1722
Fax: (386) 755-1858
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 $252.
Total Amount is formed as General ($252) + Research ($0) + Ownership ($0) = $252.
Last reported payment date: 2023-08-03 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($113).
Total Amount
$252
General + Research + Ownership
Payments
7
Total payment records
General Amount
$252
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Johnson & Johnson Vision Care, Inc. | $113 |
| BIOTISSUE HOLDINGS, INC. | $58 |
| Oyster Point Pharma, Inc. | $50 |
| Alcon Vision LLC | $31 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 | 160 | 156 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 33 | 27 | $0 |
| 92004 | New patient complete exam of visual system | 29 | 29 | $0 |
| 92134 | Imaging of retina | 27 | 27 | $0 |
| 66984 | Removal of cataract with insertion of prosthetic lens | 16 | 12 | $0 |
Insurance plans in this area (ZIP 32025)
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