JIMMY H ELAM (OD) – Optometrist, NPI 1194718379
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JIMMY H ELAM (OD)
2511, North Westwood Boulevard, Loma Linda, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639012338
Phone: (573) 686-5866
Fax: (618) 997-6250
Type: Location
PO BOX 1178
MARION, IL 629597678
Phone: (618) 993-5686
Fax: (618) 997-6250
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $76.
Total Amount is formed as General ($76) + Research ($0) + Ownership ($0) = $76.
Last reported payment date: 2023-02-10 • Largest payer in this snapshot: Johnson & Johnson Surgical Vision, Inc. ($76).
Total Amount
$76
General + Research + Ownership
Payments
1
Total payment records
General Amount
$76
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Johnson & Johnson Surgical Vision, Inc. | $76 |
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: 2007-10-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071026000501 | I | Optometry | TN | TBD |
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.
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 63901)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | MO | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 174 | 109 |
| OPTOMETRY | MO | 92083 | Measurement of field of vision during daylight conditions | 47 | 44 |
| OPTOMETRY | MO | 92134 | Diagnostic imaging of retina | 76 | 67 |
Reviews
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