Optical Gallery – Optometrist, NPI 1710166996

Optical Gallery is a healthcare provider. based in Kearney, Nebraska. specializing in Optometrist. The organization holds a License No. 1220 (NE). The NPI Number for Optical Gallery is 1710166996

Main info

Organization
Name
Optical Gallery
NPI
1710166996
Phone
(308) 234-9913
Address
220 W 39TH ST
Authorized Official
MANDY JANE JOHNSON OWNER/OPTOMETRIST
Enumeration Date
24 October 2007
Last Update Date
12 November 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Optical Gallery

  • 220, West 39th Street, Kearney, Buffalo County, Nebraska, 68845, United States

    KEARNEY, NE 688452802

    Phone: (308) 234-9913

    Fax: (308) 234-4006

    Type: Mailing

  • 5403 N AVE

    KEARNEY, NE 688478514

    Phone: (308) 234-9133

    Fax: (308) 234-4006

    Type: Mailing

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: 2008-05-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20080506000145OClinic/Group PracticeNE2024-06-30

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.

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 68845)

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Reviews

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Frequently asked questions

What number should I use to identify Optical Gallery for billing?
Administrative and clinical systems typically use NPI 1710166996 for Optical Gallery.
Does the public listing show Optical Gallery as active?
Optical Gallery's NPI record reflects an active status in NPPES.
What services align with Optical Gallery's listing?
Optical Gallery's public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to Optical Gallery?
The directory associates Optical Gallery with Kearney, Nebraska. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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