DR. COURTNEY RAY SIVERTSON O.D.
NPI 1114948734
Optometrist in Rochester, MN

Active since July 21, 2006PECOS EnrolledAccepts Medicare Assignment
3632 10TH LN NW, ROCHESTER, MN 55901(507) 282-7121 Get Directions Write a Review

NPPES record last updated: July 19, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Courtney Ray Sivertson O.d. NPPES

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

DR. COURTNEY RAY SIVERTSON O.D. (NPI 1114948734) is an individual optometrist in Rochester, Minnesota, licensed in Minnesota (3070) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2006).

NPPES Registry Identity

NPI1114948734
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. COURTNEY RAY SIVERTSONCredential: O.D.
Location Address3632 10TH LN NWRochester, MN 55901-7032
Mailing Address3632 10th Ln NwRochester, MN 55901-7032 · (507) 210-4894
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2006
Enumeration DateJuly 21, 2006
Last NPPES UpdateJuly 19, 2012
NPI 1114948734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses Licensed in MN · 3070 Licensed in UT · 6246453-9934
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.

Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 3070 (MN)
3632 10TH LN NW, Rochester, MN 55901

Other Identifiers 16

Other09Y98SIMN · Blue Cross Blue Shield
Medicare UPINV11757MN
Other09Y96LIMN · Blue Cross Blue Shield
Other411898525MN · Mayo Management Services
Other628A8SIMN · Blue Cross Blue Shield
Other916891050630MN · Preferred One
Other617A1SIMN · Blue Cross Blue Shield
OtherHP77005MN · Health Partners
Medicaid763132000MN
Other6C464ANMN · Blue Cross Blue Shield
Other09Y99LIMN · Blue Cross Blue Shield
Other39797WEMN · Blue Cross Blue Shield
Medicare PIN410002771MN
Other138801MN · Ucare
Other411898525MN · Humana
Medicare PIN410003032MN

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. Courtney Ray Sivertson 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 ID4880799105
PECOS Enrollment IDI20070416000417
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 9

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.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
167 services165 patients
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.
73 services71 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.
29 services27 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
25 services24 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
23 services23 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
18 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55901 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

Other Providers at the Same Location NPPES 10

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

Optometrist
3632 10TH LN NW, SUITE 2
ROCHESTER, MN 55901
Nurse's Aide
3632 10TH LN NW
ROCHESTER, MN 55901
Dental Assistant
3632 10TH LN NW
ROCHESTER, MN 55901
Optometrist
3632 10TH LN NW
ROCHESTER, MN 55901
Licensed Practical Nurse
3632 10TH LN NW
ROCHESTER, MN 55901
Dentist (Oral and Maxillofacial Surgery)
3632 10TH LN NW
ROCHESTER, MN 55901
Licensed Practical Nurse
3632 10TH LN NW
ROCHESTER, MN 55901
Dental Assistant
3632 10TH LN NW
ROCHESTER, MN 55901

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 Courtney Sivertson's NPI number?

The NPI number for Courtney Sivertson is 1114948734. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Courtney Sivertson located?

Courtney Sivertson practices at 3632 10th Ln NW, Rochester, MN 55901. The listed phone number is (507) 282-7121.

What is Courtney Sivertson's specialty?

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

Is Courtney Sivertson enrolled in Medicare?

Yes. Courtney Sivertson 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 Courtney Sivertson accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Medica and Providence Health Plan and 2 other insurers list Courtney Sivertson 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 Courtney Sivertson was last updated on July 19, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.