LIFETIME VISION CARE LLC – Medical Specialty Clinic/Center, NPI 1073886412

LIFETIME VISION CARE LLC is a healthcare provider. based in Bend, Oregon. specializing in Medical Specialty Clinic/Center. The NPI Number for LIFETIME VISION CARE LLC is 1073886412

Main info

Organization
Name
LIFETIME VISION CARE LLC
NPI
1073886412
Phone
(541) 382-3242
Address
901 NW CARLON AVE
Authorized Official
DR. DERRI JO SANDBERG OPTOMETRIST OD
Enumeration Date
15 February 2012
Last Update Date
15 July 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:14State licenses:0Digital endpointsOther names

Provider Addresses for LIFETIME VISION CARE LLC

  • 901 NW CARLON AVE

    SUITE 2

    BEND, OR 977032636

    Phone: (541) 382-3242

    Fax: (541) 317-3579

    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)

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: 2012-04-24

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20120424000158OClinic/Group PracticeORTBD

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.

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 97703)

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Reviews

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Frequently asked questions

Does LIFETIME VISION CARE LLC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LIFETIME VISION CARE LLC uses 1073886412.
Does CMS list LIFETIME VISION CARE LLC as active?
Yes — LIFETIME VISION CARE LLC is active in the NPI listing used on this page.
What is LIFETIME VISION CARE LLC's specialty?
The listing groups LIFETIME VISION CARE LLC with Medical Specialty Clinic/Center. Clinical services aligned with this taxonomy classification.
What area does LIFETIME VISION CARE LLC serve?
LIFETIME VISION CARE LLC's listing highlights Bend, Oregon; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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