DR. SHERRY LEE SWARTZ O.D.
NPI 1013990241
Optometrist in Grafton, WV

Active since November 22, 2005PECOS EnrolledAccepts Medicare Assignment
216 LINCOLN ST, GRAFTON, WV 26354(304) 265-1851(304) 265-0028 Get Directions Write a Review

NPPES record last updated: March 19, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 19, 2026, Jul 25, 2022 (2 updates tracked since 2022).

About Dr. Sherry Lee Swartz O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHERRY LEE SWARTZ O.D. (NPI 1013990241) is an individual optometrist in Grafton, West Virginia, licensed in West Virginia (998-OD) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS and is a graduate of Ohio State University - College Of Optometry (2001).

NPPES Registry Identity

NPI1013990241
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. SHERRY LEE SWARTZCredential: O.D.
Location Address216 LINCOLN STGrafton, WV 26354-1442
Mailing Address25 W Bluemont StGrafton, WV 26354-1242 · (304) 265-0312 · Fax (304) 265-0314
Fax(304) 265-0028
Sole ProprietorNo
Medical School CMSOhio State University - College Of OptometryGraduated 2001
Enumeration DateNovember 22, 2005
Last NPPES UpdateMarch 19, 20262 updates tracked since enumeration
NPPES CertifiedMarch 19, 2026
NPI 1013990241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in WV · 998-OD
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
216 LINCOLN ST, Grafton, WV 26354

Other Names 1

Former Name (1)Dr. Sherry Lee Knotts

Other Identifiers 2

Medicaid1013990241WV
OtherWVF926P793WV · Medicare

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Sherry Lee Swartz O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476677295
PECOS Enrollment IDI20100901000042
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
195 services175 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
38 services24 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
30 services30 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%52 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%277 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims11 services$52.05 avg. paid by Medicare
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier12 claims22 services$45.19 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
216 LINCOLN ST
GRAFTON, WV 26354
Clinic/Center (Federally Qualified Health Center (FQHC))
216 LINCOLN ST
GRAFTON, WV 26354
Optometrist
216 LINCOLN ST
GRAFTON, WV 26354

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sherry Swartz's NPI number?

The NPI number for Sherry Swartz is 1013990241. It was assigned to this individual provider in the NPPES registry on November 22, 2005. The provider is also known as Dr. Sherry Lee Knotts.

Where is Sherry Swartz located?

Sherry Swartz practices at 216 Lincoln St, Grafton, WV 26354. The listed phone number is (304) 265-1851.

What is Sherry Swartz's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Sherry Swartz enrolled in Medicare?

Yes. Sherry Swartz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sherry Swartz accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Sherry Swartz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sherry Swartz was last updated on March 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.