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DAVID SCOTT SYBESMA OD PC
NPI 1255392122
Optometrist in Maquoketa, IA

Active since March 30, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
1408 43RD STREET, MAQUOKETA, IA 52060(563) 652-2795(563) 652-5210 Get Directions Write a Review

NPPES record last updated: December 13, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About David Scott Sybesma Od Pc NPPES

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

DAVID SCOTT SYBESMA OD PC (NPI 1255392122) is an individual optometrist in Maquoketa, Iowa, licensed in Iowa (1996) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1992).

NPPES Registry Identity

NPI1255392122
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDAVID SCOTT SYBESMACredential: OD PC
Location Address1408 43RD STREETMaquoketa, IA 52060
Mailing Address1408 43rd StreetMaquoketa, IA 52060 · (563) 652-2795 · Fax (563) 652-5210
Phone(563) 652-2795
Fax(563) 652-5210
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1992
Enumeration DateMarch 30, 2006
Last NPPES UpdateDecember 13, 2014
✔ NPI 1255392122 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 IA · 1996
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.
1408 43RD STREET, Maquoketa, IA 52060
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Other Identifiers 5

Medicare UPINU47298
Other14965IA · Wellmark Bcbs
Other410024770Railroad Medicare
Other5380340001Cigna Dme Region D
Medicaid1106880IA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David Scott Sybesma Od Pc 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 ID5698765261
PECOS Enrollment IDI20040518000265
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.

Medicare Billing Reassignment

Medicare enrollment records show David Sybesma reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

David S Sybesma, Od, PC
Same address
Optometrist
1408 43RD STREET
Maquoketa, IA 52060
  • Reassigned Medicare billing, Iowa enrollment
NPI 1447474630 (563) 652-2795

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

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.
551 services532 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.
231 services209 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).
152 services123 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
104 services73 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.
86 services73 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.
83 services69 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52060 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
$122.23 typical visit price
range $52.96 – $161.40
Typical copayment $30.55 (range $13.24 – $40.35)
Most-billed visit code 99204
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

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
98%222 patients4/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
100%56 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,144 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%208 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
2%45 patients1/55-star benchmark: 96%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%1,246 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
55%2,543 patients3/55-star benchmark: 99%
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…
30%110 patients2/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 1,047 patients
Patients tobacco: 98% · 1,047 patients
75%80 patients4/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%58 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
61%2,543 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%2,543 patients1/55-star benchmark: 59%
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 3

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 supplier24 claims24 services$47.28 avg. paid by Medicare
Sphere, bifocal, plano to plus or minus 4.00d, per lens V2200
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims22 services$43.87 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier18 claims36 services$53.13 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

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

DAVID S SYBESMA, OD, PC
Optometrist
1408 43RD STREET
MAQUOKETA, IA 52060
Jackson County (563) 652-2795

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 David Sybesma's NPI number?

The NPI number for David Sybesma is 1255392122. It was assigned to this individual provider in the NPPES registry on March 30, 2006.

Where is David Sybesma located?

David Sybesma practices at 1408 43rd Street, Maquoketa, IA 52060. The listed phone number is (563) 652-2795.

What is David Sybesma's specialty?

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

Is David Sybesma enrolled in Medicare?

Yes. David Sybesma 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.

Which organization bills Medicare for David Sybesma's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Sybesma reassigns Medicare benefits to David S Sybesma, Od, PC (Maquoketa, IA). The 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 David Sybesma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does David Sybesma accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Oscar Health and 7 other insurers list David Sybesma 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 David Sybesma was last updated on December 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.