Ka-Eul Kelly Yim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001452 Issued in PA

Practice address

47 Cheltenham Ave
Cheltenham, PA 19012-1412

Phone

(215) 635-4787

Fax

(215) 758-2628

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• J H Lee OD & Associates PC

  • Optometrist
  • Abington, PA
  • NPI 1053366427
  Medicare reassignment NPD
• Design Eyes

  • Optician
  • Cheltenham, PA
  • NPI 1578576104

  Optometrist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1003860255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CHELTENHAM AVE",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121412",
            "telephone_number": "215-635-4787",
            "fax_number": "215-758-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CHELTENHAM AVE",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121412",
            "telephone_number": "215-635-4787",
            "fax_number": "215-758-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "KA-EUL",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "1745507",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly Jane Waldman, MS, RD
• Cameron Wallace
• P Kenneth Weidler, D.M.D.
• Robert Williford, MSS
• Jabez Yeo

• Optometrist in Cheltenham, PA
• Providers in Cheltenham, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.