FAMILY VISION CLINIC
NPI 1104237601
Optometrist in Cody, WY
About Family Vision Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY VISION CLINIC (NPI 1104237601) is a healthcare organization registered as an optometrist in Cody, Wyoming and active in the NPI registry since May 2014. The organization lists Jacob G Despain, Optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Family Vision Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Family Vision Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medical Equipment Supplier Medicare DMEPOS 2
Medicare supplier enrollment and the product categories Family Vision Clinic carries, from the Medicare DMEPOS supplier directory.
Family Vision Clinic
DMEPOS supplier · Cody, WYOperated by Jacob G Despain Od PCAccepts Medicare assignment
Family Vision Clinic agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Product Categories
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 Jacob G. Despain Od PC's NPI number?
The NPI number for Jacob G. Despain Od PC is 1104237601. It was assigned to this organization in the NPPES registry on May 19, 2014. The provider is doing business as Family Vision Clinic.
Where is Jacob G. Despain Od PC located?
Jacob G. Despain Od PC is located at 1708 Stampede Ave, Cody, WY 82414. The listed phone number is (307) 587-2404.
What is Jacob G. Despain Od PC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Jacob G. Despain Od PC enrolled in Medicare?
Yes. Jacob G. Despain Od PC is registered in the Medicare PECOS enrollment system.
When is Jacob G. Despain Od PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Wyoming, Physician - Optometrist) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jacob G. Despain Od PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Jacob G. Despain Od PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jacob G. Despain Od PC accept Medicare assignment for medical equipment?
Yes. As a Medicare medical equipment supplier, Family Vision Clinic accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.
What insurance does Jacob G. Despain Od PC accept?
Health plans from Blue Cross Blue Shield of Wyoming list Jacob G. Despain Od PC 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 Jacob G. Despain Od PC was last updated on May 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.
# Family Vision Clinic · NPI 1104237601
Optometrist organization in Cody, Wyoming. Organization record, active in the CMS NPPES registry since May 19, 2014.
## Identity
- **NPI:** 1104237601 (Entity type: Organization)
- **Enumerated:** May 19, 2014
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Jacob G. Despain Od Pc
- **Organization subpart:** No
- **Authorized official:** Jacob Despain, OPTOMETRIST
## Practice location
- **Address:** 1708 STAMPEDE AVE, Cody, WY 82414-4829
- **Phone:** (307) 587-2404 · **Fax:** (307) 527-7368
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (DME, Wyoming, Physician - Optometrist) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 19, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1104237601) · Data from the CMS NPPES public registry.