St. Elizabeth Physicians – Ophthalmology Physician, NPI 1780959833
Ophthalmology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for St. Elizabeth Physicians
2300 CHAMBER CENTER DR
SU. 200
LAKESIDE PARK, KY 410171673
Phone: (859) 344-5555
Fax: (859) 344-5552
Type: Mailing
1974 WALTON NICHOLSON PIKE
INDEPENDENCE, KY 410517906
Phone: (859) 356-6800
Fax: (859) 363-4073
Type: Location
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 410110801
Phone: (859) 655-3111
Fax: (859) 655-3110
Type: Location
1360 DOLWICK DR
ERLANGER, KY 410183127
Phone: (859) 344-5555
Fax: (859) 344-5552
Type: Mailing
1500 JAMES SIMPSON JR WAY STE 201
COVINGTON, KY 410110802
Phone: (859) 655-3111
Fax: (859) 655-3110
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: 2012-06-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (710 days ago).
Enrollment records
1
Earliest due date
2024-06-30
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 |
|---|---|---|---|---|
| O20120614000172 | O | Physician - Family Practice | KY | 2024-06-30 |
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.
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 41017)
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