Individual provider Active NPI

Jared Kellar, O.D.

  • Optometrist
  • Mason City, IA
National Provider Identifier
1205032331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002393 Issued in IA
Practice address
595 S Illinois Ave
Mason City, IA 50401-4441
Phone
(641) 425-5916
NPI assigned
Jun 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002393 IA Primary

Addresses

Primary practice location

595 S Illinois Ave
Mason City, IA 50401-4441

Mailing address

1521 Plymouth Rd
Mason City, IA 50401-1411
Phone (641) 425-5916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20070813000180 IA Practitioner - Optometry 8224129754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

595 S Illinois Ave
Mason City, IA 50401-4441
Phone (641) 422-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clear View Eye Clinic, Inc Optometrist CurrentSince Aug 1, 2007 Accepting new patients

Locations

595 S Illinois Ave
Mason City, IA 50401
Phone (641) 422-3937

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205032331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 PLYMOUTH RD",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011411",
            "telephone_number": "641-425-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 S ILLINOIS AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504014441",
            "telephone_number": "641-425-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAR",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.