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DR. CAROL ALLEN OD
NPI 1902941537
Optometrist in Fort Gratiot, MI

Active since February 21, 2007PECOS Enrolled
3957 24TH AVE, FORT GRATIOT, MI 48059(810) 984-5005 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Carol Allen Od NPPES

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

DR. CAROL ALLEN OD (NPI 1902941537) is an individual optometrist in Fort Gratiot, Michigan, licensed in Michigan (4901004371) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1902941537
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. CAROL ALLENCredential: OD
Location Address3957 24TH AVEFort Gratiot, MI 48059-4102
Mailing Address8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442 · (703) 847-8899
Phone(810) 984-5005
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateFebruary 21, 2007
Last NPPES UpdateJune 29, 2023
NPPES CertifiedJune 29, 2023
✔ NPI 1902941537 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 · 4901004371
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.
3957 24TH AVE, Fort Gratiot, MI 48059
Open in Google Maps ↗

Other Identifiers 1

Other929491MI · Block Vision

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 (PECOS)

Dr. Carol Allen Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264735018
PECOS Enrollment IDI20160128000708
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 Carol Allen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Myeyedr Optometry Of Michigan, LLC
Same address
Optometrist
3957 24TH AVE
Fort Gratiot, MI 48059
  • Reassigned Medicare billing, Michigan enrollment
  • 144 clinicians in this Medicare group
NPI 1598359424 (810) 984-5005
Blue Water Eye Care Associates PC
4.8 mi
Ophthalmology
2603 ELECTRIC AVE STE 1
Port Huron, MI 48060
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Blue Water Eye Care Associates, P.C.
  • 2 clinicians in this Medicare group
NPI 1104081819 (810) 982-1300

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 3

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 office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
25 services18 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.
20 services20 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.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48059 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.

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.

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
94%48 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
91%46 patients4/55-star benchmark: 100%
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
92%148 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%25 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.
75%728 patients1/55-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%170 patients3/55-star benchmark: 100%
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%35 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…
54%170 patients3/55-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 5

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

C & T ENTERPIRSES, INC.
Optometrist
3957 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 984-5005
CARSON DAY OD
Optometrist
3957 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 984-5005
THOMAS LEES OD
Optometrist
3957 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 984-5005
MYEYEDR OPTOMETRY OF MICHIGAN, LLC
Optometrist
3957 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 984-5005
C&T ENTERPRISES, INC.
Optometrist
3957 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 984-5005

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 Carol Allen's NPI number?

The NPI number for Carol Allen is 1902941537. It was assigned to this individual provider in the NPPES registry on February 21, 2007.

Where is Carol Allen located?

Carol Allen practices at 3957 24th Ave, Fort Gratiot, MI 48059. The listed phone number is (810) 984-5005.

What is Carol Allen's specialty?

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

Is Carol Allen enrolled in Medicare?

Yes. Carol Allen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Carol Allen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carol Allen reassigns Medicare benefits to 2 organizations: Myeyedr Optometry Of Michigan, LLC (Fort Gratiot, MI) and Blue Water Eye Care Associates PC (Port Huron, 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 Carol Allen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carol Allen 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 17 other insurers list Carol Allen 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 Carol Allen was last updated on June 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.