Kennedy Vision Health Center LLC

A Medicare group practice based in Otsego, MN: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 9739173659), with 7 clinicians.

Medicare enrollment

PAC ID: 9739173659The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type: DME Supplier - Physician - Optometrist, Part B Supplier - Clinic/Group Practice
Enrolled in: MN
Enrollments: 3
Group size: 7 cliniciansAs Care Compare reports it
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Practice locations: 5In 3 places

Enrollment ID	State	Provider type	NPI
O20100930097353	MN	DME Supplier - Physician - Optometrist	1033203963
O20241230001639	MN	DME Supplier - Physician - Optometrist	1255165932
O20040413001418	MN	Part B Supplier - Clinic/Group Practice	1033203963

These NPI records belong to the same enrolled organization. Each has its own page.

Locations on the Medicare enrollment

Clinicians who reassign their Medicare benefits to this group (7) or whom Care Compare lists as members (7).

Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
NPPES NPI Registry: the names and addresses of the NPIs above.