DR. JACQUELIN ESCOTO BENITEZ (OD) – Optometrist, NPI 1053084343
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JACQUELIN ESCOTO BENITEZ (OD)
1570 Wilmington Dr Ste 160
DuPont, WA 983278773
Phone: (253) 434-2733
Type: Location
10231 MIDDLEGLEN LN
HOUSTON, TX 770343789
Phone:
Type: Mailing
19052 GULF FWY
FRIENDSWOOD, TX 775462703
Phone: (281) 238-5124
Type: Location
7619 RUSHMORE WAY NE
LACEY, WA 985161340
Phone:
Type: Mailing
215 LILLY RD NE
OLYMPIA, WA 985065030
Phone: (360) 923-4333
Fax: (360) 456-3894
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $216.
Total Amount is formed as General ($216) + Research ($0) + Ownership ($0) = $216.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: BIOTISSUE HOLDINGS INC. ($57).
Total Amount
$216
General + Research + Ownership
Payments
7
Total payment records
General Amount
$216
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-01-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20211015002430 | I | Optometry | TX | TBD |
| I20230131003270 | I | Optometry | WA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 364 | 364 | $0 |
| 92004 | New patient complete exam of visual system | 109 | 109 | $0 |
| 92134 | Imaging of retina | 93 | 93 | $0 |
| 92133 | Imaging of optic nerve | 69 | 66 | $0 |
| 92250 | Photography of the retina | 66 | 64 | $0 |
Insurance plans in this area (ZIP 98327)
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