ROSE OPTICAL, INC. – Optometrist, NPI 1669444063

ROSE OPTICAL, INC. is a healthcare provider. based in Godfrey, Illinois. specializing in Optometrist. The organization holds a License No. 22652655 (IL). The NPI Number for ROSE OPTICAL, INC. is 1669444063

Main info

Organization
Name
ROSE OPTICAL, INC.
NPI
1669444063
Phone
(618) 466-8787
Address
PO BOX 5040
Authorized Official
MRS. MARIE ANNETTE MANGRUM BOARD SECRETARY/TREAS.
Enumeration Date
2 February 2006
Last Update Date
29 August 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for ROSE OPTICAL, INC.

  • Godfrey Post Office, Tolle Lane, Godfrey, Madison County, Illinois, 62035, United States

    GODFREY, IL 620355040

    Phone: (618) 466-8787

    Fax: (618) 466-4703

    Type: Mailing

  • Godfrey Rd, Godfrey Road, Hiawatha, Minneapolis, Hennepin County, Minnesota, 55406, United States

    GODFREY, IL 620352558

    Phone: (618) 466-8787

    Fax: (618) 466-4703

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2008-02-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (313 days ago).

Enrollment records

1

Earliest due date

2025-07-31

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
O20080229000685OClinic/Group PracticeIL2025-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 62035)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for ROSE OPTICAL, INC.?
The registry entry for ROSE OPTICAL, INC. shows NPI 1669444063.
Is ROSE OPTICAL, INC. currently accepting referrals based on NPI status?
Registry metadata lists ROSE OPTICAL, INC. as active.
How should patients interpret ROSE OPTICAL, INC.'s specialty?
The extract shows Optometrist for ROSE OPTICAL, INC.. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ROSE OPTICAL, INC.?
ROSE OPTICAL, INC. is associated with Godfrey, Illinois in the same public data insurers reference.
Why is information missing for ROSE OPTICAL, INC.?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

Similar Providers

1310 Dadrian Professional Park
NPI: 1376586685
Godfrey Rd, Godfrey Road, Hiawatha, Minneapolis, Hennepin County, Minnesota, 55406, United States
NPI: 1720170921
Godfrey Rd, Godfrey Road, Hiawatha, Minneapolis, Hennepin County, Minnesota, 55406, United States
NPI: 1467533661
2020 W Iles Ave
NPI: 1316086580
3300 GODFREY RD
NPI: 1598897456
Godfrey Rd, Godfrey Road, Hiawatha, Minneapolis, Hennepin County, Minnesota, 55406, United States
NPI: 1861614810
PO BOX 5040
NPI: 1780850032
PO BOX 5040
NPI: 1174774079
3990 N Illinois St
NPI: 1649405218