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DR. SAMMY L PELLETIER OD
NPI 1609841360
Optometrist in York, ME

Active since February 17, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
764 ROUTE ONE, UNIT 6, YORK, ME 03909(207) 363-7555(207) 363-1711 Get Directions Write a Review

NPPES record last updated: October 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sammy L Pelletier Od NPPES

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

DR. SAMMY L PELLETIER OD (NPI 1609841360) is an individual optometrist in York, Maine, licensed in Maine (OPT729) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1983).

NPPES Registry Identity

NPI1609841360
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. SAMMY L PELLETIERCredential: OD
Location Address764 ROUTE ONE, UNIT 6York, ME 03909-5879
Mailing Address764 Route One, Unit 6York, ME 03909-5879 · (207) 363-7555 · Fax (207) 363-1711
Phone(207) 363-7555
Fax(207) 363-1711
Sole ProprietorYes
Medical School CMSPennsylvania College Of OptometryGraduated 1983
Enumeration DateFebruary 17, 2006
Last NPPES UpdateOctober 29, 2015
✔ NPI 1609841360 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 ME · OPT729
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.
764 ROUTE ONE, York, ME 03909
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Other Identifiers 11

OtherMNT038ME · Harvard Pilgrim Prov. #
Other5021708ME · Cigna Provider #
OtherM22891ME · Cigna Provider #
Other09Y000292ME01ME · Blue Cross Provider #
Other30009894ME · Nh Medicaid
Other2237986ME · Aetna Prov. #
Medicare UPINU20239ME
Medicaid130570000ME
OtherMM4138Medicare
Other018152ME · Star #
Medicare ID-Type Unspecified1146970001ME · Healthnow Prov. #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.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. Sammy L Pelletier Od 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 ID1052496007
PECOS Enrollment IDI20080819000418
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 10

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.
286 services284 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.
191 services122 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.
167 services152 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.
152 services104 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).
117 services99 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.
112 services106 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03909 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
$128.83 typical visit price
range $56.28 – $169.96
Typical copayment $32.20 (range $14.07 – $42.49)
Most-billed visit code 99204
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

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.
93%73 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
97%503 patients4/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
28%503 patients2/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
1%503 patients1/55-star benchmark: 75%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
44%50 patients
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.

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 Sammy Pelletier's NPI number?

The NPI number for Sammy Pelletier is 1609841360. It was assigned to this individual provider in the NPPES registry on February 17, 2006.

Where is Sammy Pelletier located?

Sammy Pelletier practices at 764 Route One Unit 6, York, ME 03909. The listed phone number is (207) 363-7555.

What is Sammy Pelletier's specialty?

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

Is Sammy Pelletier enrolled in Medicare?

Yes. Sammy Pelletier 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 Sammy Pelletier accept?

Health plans from Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Sammy Pelletier 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 Sammy Pelletier was last updated on October 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.