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DR. JEFFREY RICHARD SUTTON O.D.
NPI 1255526232
Optometrist in Boone, NC

Active since September 12, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
717 GREENWAY RD, SUITE C, BOONE, NC 28607(828) 265-2020(828) 264-2257 Get Directions Write a Review

NPPES record last updated: August 12, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jeffrey Richard Sutton O.d. NPPES

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

DR. JEFFREY RICHARD SUTTON O.D. (NPI 1255526232) is an individual optometrist in Boone, North Carolina, licensed in North Carolina (1300) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1988).

NPPES Registry Identity

NPI1255526232
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JEFFREY RICHARD SUTTONCredential: O.D.
Location Address717 GREENWAY RD, SUITE CBoone, NC 28607-4991
Mailing Address717 Greenway Rd, Suite CBoone, NC 28607-4991 · (828) 265-2020 · Fax (828) 264-2257
Phone(828) 265-2020
Fax(828) 264-2257
Sole ProprietorYes
Medical School CMSPennsylvania College Of OptometryGraduated 1988
Enumeration DateSeptember 12, 2007
Last NPPES UpdateAugust 12, 2013
✔ NPI 1255526232 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 NC · 1300
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.
717 GREENWAY RD, Boone, NC 28607
Open in Google Maps ↗

Other Identifiers 5

Medicare PIN2341873NC
Other1780805804NC · Group Npi #
Other09826NC · Bcbsnc
Medicare UPINT81639NC
Medicaid8909826NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Oscar 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

Dr. Jeffrey Richard Sutton 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 ID6800845959
PECOS Enrollment IDI20050124000594
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 Reassignments

2

Medicare enrollment records show Jeffrey Sutton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eyecarecenter Od PA
1.5 mi
Optometrist
275 E KING ST STE A
Boone, NC 28607
  • Reassigned Medicare billing, North Carolina enrollment
  • 137 clinicians in this Medicare group
NPI 1649759341 (828) 265-2020
Wilcox Optometry PLLC
217 mi
Optometrist
800 TIFFANY BLVD STE 101
Rocky Mount, NC 27804
  • Reassigned Medicare billing, North Carolina enrollment
  • 16 clinicians in this Medicare group
NPI 1407529696 (502) 244-2420

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 7

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.

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.
375 services375 patients
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.
313 services313 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.
136 services134 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
43 services43 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
35 services34 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28607 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality89.99
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Advance Care Plan
100%38 patients5/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
71%245 patients1/55-star benchmark: 100%
Diabetes: Eye Exam
100%338 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
98%2,150 patients4/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
99%186 patients
Provide Patients Electronic Access to Their Health Information
92%593 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 1,774 patients
Patients totalRate: 0% · 1,774 patients
0%1,774 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.

Other Providers at the Same Location NPPES

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

GOLDMAN CENTER FOR FACIAL PLASTIC SURGERY PLLC
Otolaryngology (Facial Plastic Surgery)
717 GREENWAY RD, SUITE A
BOONE, NC 28607
Watauga County (828) 278-9230

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 Jeffrey Sutton's NPI number?

The NPI number for Jeffrey Sutton is 1255526232. It was assigned to this individual provider in the NPPES registry on September 12, 2007.

Where is Jeffrey Sutton located?

Jeffrey Sutton practices at 717 Greenway Rd Suite C, Boone, NC 28607. The listed phone number is (828) 265-2020.

What is Jeffrey Sutton's specialty?

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

Is Jeffrey Sutton enrolled in Medicare?

Yes. Jeffrey Sutton 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 organizations bill Medicare for Jeffrey Sutton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Sutton reassigns Medicare benefits to 2 organizations: Eyecarecenter Od PA (Boone, NC) and Wilcox Optometry PLLC (Rocky Mount, NC). 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 Jeffrey Sutton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Sutton accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Oscar Health, Oscar Health Insurance and Oscar Health Maintenance Organization of Florida and 5 other insurers list Jeffrey Sutton 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 Jeffrey Sutton was last updated on August 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.