Active NPI 1346209020 Individual Practitioner Male Practitioner

Dr. Wallace Scott Johnson , OD

Optometrist • Pillager, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Wallace Johnson, OD is a certified Optometrist practicing in Pillager, MN. With approximately 38 years of clinical experience since completing medical education in 1988, Dr. Johnson delivers high-quality medical care to the local community at 775 BUCKSKIN AVE W.

Dr. Johnson is affiliated with Up North Eye Care Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, established patient complete exam of visual system, new patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

775 Buckskin Ave W

Pillager, MN 564732509

Telephone 2187462020

Fax 2185200654

Associated Practice Facility / Clinic

🏢 Up North Eye Care, P.a. Facility NPI 1497389944

Medicare Profile & Education

Medical School

Other

Graduation Year

1988

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Pillager, MN

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

38 Yrs +9.0 yrs vs City Avg

City Avg: 29.0 Yrs

State Avg: 21.7 Yrs

Regional Practice Density

2 Specialists

Practicing in Pillager, MN (1178 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

24.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Johnson (38 Years) 38 Yrs

Pillager Specialty Average (29.0 Years) 29.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	23	17	$127.10	$88.09
92014 Established patient complete exam of visual system	22	22	$162.79	$124.47
92004 New patient complete exam of visual system	13	13	$185.32	$146.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	22	16	$127.10	$88.03
92014 Established patient complete exam of visual system	20	20	$156.87	$126.22
92004 New patient complete exam of visual system	17	17	$173.43	$149.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,710	13	$1.77	$1.13
92014 Established patient complete exam of visual system	263	263	$128.15	$121.47
92250 Photography of the retina	99	99	$82.21	$35.34
99213 Established patient office or other outpatient visit, typically 15 minutes	98	80	$77.79	$74.83
92134 Imaging of retina	71	71	$99.60	$38.50
92004 New patient complete exam of visual system	39	39	$156.97	$145.36
92083 Exam of visual field with extended testing	38	38	$121.65	$60.52
92133 Imaging of optic nerve	37	37	$100.00	$33.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	5,532	39	$1.81	$1.14
66982 Complex removal of cataract with insertion of prosthetic lens	1,976	18	$2.07	$1.56
92014 Established patient complete exam of visual system	456	451	$128.00	$121.87
92250 Photography of the retina	217	207	$82.00	$37.36
99213 Established patient office or other outpatient visit, typically 15 minutes	200	151	$74.00	$74.00
92134 Imaging of retina	124	115	$100.00	$39.11
92004 New patient complete exam of visual system	100	100	$154.00	$144.87
92133 Imaging of optic nerve	74	67	$100.00	$34.44
92083 Exam of visual field with extended testing	73	69	$123.00	$61.13
83861 Microfluid analysis of tears	56	27	$25.00	$22.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	36	34	$46.00	$46.00
83516 Analysis of substance using immunoassay technique	36	18	$30.00	$11.53
92012 Established patient problem focused exam of visual system	17	17	$89.00	$86.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	5,341	41	$1.79	$1.23
92014 Established patient complete exam of visual system	344	343	$128.00	$128.43
92250 Photography of the retina	149	146	$82.00	$45.72
99213 Established patient office or other outpatient visit, typically 15 minutes	124	96	$74.00	$74.64
92134 Imaging of retina	86	81	$108.00	$41.42
92083 Exam of visual field with extended testing	50	49	$123.00	$64.86
92133 Imaging of optic nerve	48	47	$108.00	$36.84
92004 New patient complete exam of visual system	42	42	$154.00	$153.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	4,858	42	$1.87	$1.42
92014 Established patient complete exam of visual system	465	463	$128.00	$127.85
92250 Photography of the retina	210	208	$82.00	$50.85
99213 Established patient office or other outpatient visit, typically 15 minutes	189	148	$74.00	$73.91
92134 Imaging of retina	99	93	$108.00	$41.38
92004 New patient complete exam of visual system	79	79	$154.00	$152.69
92083 Exam of visual field with extended testing	57	56	$123.00	$65.20
92133 Imaging of optic nerve	54	53	$107.72	$36.36
83861 Microfluid analysis of tears	50	25	$25.00	$22.03
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	33	$46.00	$45.09
83516 Analysis of substance using immunoassay technique	32	16	$30.00	$12.55
92012 Established patient problem focused exam of visual system	30	29	$89.00	$88.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	6,164	45	$1.78	$1.37
92014 Established patient complete exam of visual system	468	466	$128.00	$122.62
92250 Photography of the retina	191	190	$82.00	$55.26
99213 Established patient office or other outpatient visit, typically 15 minutes	172	124	$74.00	$69.82
92134 Imaging of retina	125	113	$108.00	$40.33
92133 Imaging of optic nerve	69	62	$105.00	$35.65
92083 Exam of visual field with extended testing	48	47	$123.00	$62.78
92004 New patient complete exam of visual system	39	39	$154.00	$146.56
92012 Established patient problem focused exam of visual system	22	22	$89.00	$85.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	4,484	38	$1.84	$1.39
92014 Established patient complete exam of visual system	408	405	$128.00	$119.65
92250 Photography of the retina	171	168	$82.00	$64.14
99213 Established patient office or other outpatient visit, typically 15 minutes	154	124	$74.00	$69.65
92134 Imaging of retina	90	78	$71.52	$39.63
92133 Imaging of optic nerve	57	50	$71.57	$35.47
92004 New patient complete exam of visual system	50	50	$154.00	$144.14
92083 Exam of visual field with extended testing	39	38	$123.00	$60.72
92012 Established patient problem focused exam of visual system	19	19	$89.00	$82.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	12	$46.00	$41.61

Medical Specialties & State Licenses

CMS Verified: 2025-07-24

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MN 2196

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.

Optometrist - Corneal and Contact Management

NUCC Taxonomy Code: 152WC0802X

State License MN 2196

The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

970525200 (MN)

Commercial Insurance / Payer ID Mpin

63372 (MN)

Hospital & Practice Group Affiliations

Up North Eye Care Pa

775 Buckskin Ave W, Pillager, MN 564732509

Phone: 2187462020

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Stephanie Parrish , OD

Optometrist

NPI 1225057755

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location July 24, 2025

Registered at 775 BUCKSKIN AVE W, PILLAGER, MN 564732509 (Tel: 2187462020)

📍

Updated Business Mailing Address July 24, 2025

Registered at 775 BUCKSKIN AVE W STE 1, PILLAGER, MN 564732509 (Tel: 2187462020)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2025

Optometrist (License #2196 in MN)

✅

NPI Profile Active March 03, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location March 03, 2015

Registered at 702 10TH ST, WORTHINGTON, MN 561872767 (Tel: 5073765535)

📍

Updated Business Mailing Address March 03, 2015

Registered at PO BOX 726, WORTHINGTON, MN 561870726 (Tel: 5073765535)

👤

Provider Name / Credentials Updated March 03, 2015

Recorded as WALLACE JOHNSON, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2015

Optometrist (License #2196 in MN)

🟢

Initial NPI Registration & Enumeration March 21, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346209020

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 21, 2006

Last Update: July 24, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

775 Buckskin Ave W Ste 1

Pillager, MN 564732509

Phone: 2187462020

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.