ELAINE PYNG OETOMO
NPI 1235798174
Optometrist in Glendale, AZ
About Elaine Pyng Oetomo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELAINE PYNG OETOMO (NPI 1235798174) is an individual optometrist in Glendale, Arizona, licensed in Arizona (OPT-002345) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Scottsdale.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elaine Pyng Oetomo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Elaine Oetomo reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Phoenix, AZ 85003
- Reassigned Medicare billing, Arizona enrollment
- 5 clinicians in this Medicare group
Tempe, AZ 85288
- Reassigned Medicare billing, Arizona enrollment
- 139 clinicians in this Medicare group
Scottsdale, AZ 85260
- Reassigned Medicare billing, Arizona enrollment
- 2 clinicians in this Medicare group
Scottsdale, AZ 85256
- Reassigned Medicare billing, Texas enrollment
- 147 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLENDALE, AZ 85305
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 Elaine Oetomo's NPI number?
The NPI number for Elaine Oetomo is 1235798174. It was assigned to this individual provider in the NPPES registry on June 12, 2019.
Where is Elaine Oetomo located?
Elaine Oetomo practices at 9340 W Northern Ave Ste 120, Glendale, AZ 85305. The listed phone number is (602) 794-1608.
What is Elaine Oetomo's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Elaine Oetomo enrolled in Medicare?
Yes. Elaine Oetomo is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Elaine Oetomo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elaine Oetomo reassigns Medicare benefits to 4 organizations: Optical Expressions PLLC (Phoenix, AZ), Nationwide Optometry P.C. (Tempe, AZ), Serena Shao Od PLLC (Scottsdale, AZ) and Salt River Pima-Maricopa Indian Community (Scottsdale, AZ). Each 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 Elaine Oetomo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Elaine Oetomo accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 10 other insurers list Elaine Oetomo 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 Elaine Oetomo was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Elaine Pyng Oetomo · NPI 1235798174
Optometrist provider in Glendale, Arizona. Individual provider, active in the CMS NPPES registry since June 12, 2019.
## Identity
- **NPI:** 1235798174 (Entity type: Individual)
- **Enumerated:** June 12, 2019
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPT-002345 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 9340 W NORTHERN AVE STE 120, Glendale, AZ 85305-1148
- **Phone:** (602) 794-1608
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Optical Expressions PLLC (NPI 1013141399, Phoenix, AZ); Nationwide Optometry P.C. (NPI 1326472945, Tempe, AZ); Serena Shao Od PLLC (NPI 1174293898, Scottsdale, AZ); Salt River Pima-Maricopa Indian Community (NPI 1942668991, Scottsdale, AZ) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 24, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1235798174) · Data from the CMS NPPES public registry.