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PHILIP PELTON
NPI 1275117319
Optometrist in Portage, MI

Active since May 05, 2021PECOS EnrolledAccepts Medicare Assignment
255 ROMENCE RD, PORTAGE, MI 49024(269) 324-0800(269) 324-0894 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 14, 2025, Feb 6, 2023, May 26, 2021 and 1 more (4 updates tracked since 2021).

About Philip Pelton NPPES

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

PHILIP PELTON (NPI 1275117319) is an individual optometrist in Portage, Michigan, licensed in Michigan (4901005543) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (2021).

NPPES Registry Identity

NPI1275117319
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NamePHILIP PELTON
Location Address255 ROMENCE RDPortage, MI 49024-3439
Mailing Address8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442 · (703) 847-8899 · Fax (571) 223-6780
Phone(269) 324-0800
Fax(269) 324-0894
Sole ProprietorNo
Medical School CMSFerris State College - College Of OptometryGraduated 2021
Enumeration DateMay 5, 2021
Last NPPES UpdateNovember 14, 20254 updates tracked since enumeration
NPPES CertifiedNovember 14, 2025
✔ NPI 1275117319 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 MI · 4901005543
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.
255 ROMENCE RD, Portage, MI 49024
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Philip Pelton 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 ID7618376484
PECOS Enrollment IDI20210527000783
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

3

Medicare enrollment records show Philip Pelton reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Myeyedr Optometry Of Michigan, LLC
0.9 mi
Optometrist
6123 S WESTNEDGE AVE
Portage, MI 49002
  • Reassigned Medicare billing, Michigan enrollment
  • 144 clinicians in this Medicare group
NPI 1790360220 (269) 327-7079
Hiemstra Optical Company
16 mi
Optician
133 E MICHIGAN AVE
Paw Paw, MI 49079
  • Reassigned Medicare billing, Michigan enrollment
  • 13 clinicians in this Medicare group
NPI 1841371556 (269) 657-7288
Mid Michigan Eye Care Center, PC
60 mi
Ophthalmology
1116 W. GANSON STREET
Jackson, MI 49202
  • Reassigned Medicare billing, Michigan enrollment
  • 26 clinicians in this Medicare group
NPI 1649275041 (877) 852-8463

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 49024 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

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 Philip Pelton's NPI number?

The NPI number for Philip Pelton is 1275117319. It was assigned to this individual provider in the NPPES registry on May 5, 2021.

Where is Philip Pelton located?

Philip Pelton practices at 255 Romence Rd, Portage, MI 49024. The listed phone number is (269) 324-0800.

What is Philip Pelton's specialty?

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

Is Philip Pelton enrolled in Medicare?

Yes. Philip Pelton 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 Philip Pelton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Philip Pelton reassigns Medicare benefits to 3 organizations: Myeyedr Optometry Of Michigan, LLC (Portage, MI), Hiemstra Optical Company (Paw Paw, MI) and Mid Michigan Eye Care Center, PC (Jackson, MI). 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 Philip Pelton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Philip Pelton accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 14 other insurers list Philip Pelton 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 Philip Pelton was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.