Caleb Joseph Kennedy, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

004146 Issued in FL

Practice address

18503 Pines Blvd Ste 205
Pembroke Pines, FL 33029-1405

Phone

(954) 430-8330

Fax

(954) 430-3638

NPI assigned

Jun 26, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Optometry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kennedy Vision PA

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1104167345
  Medicare reassignment NPD Authorized official
• Scott M Pearl OD PA

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1437362605
  NPD

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1205064334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291405",
            "telephone_number": "954-430-8330",
            "fax_number": "954-430-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291405",
            "telephone_number": "954-430-8330",
            "fax_number": "954-430-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CALEB",
        "middle_name": "JOSEPH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4146",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "004146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley D Keen
• Nicole Tahnee Keet
• Faith Brunhille Kellier-Dunn, AGPCNP-BC
• Ryan Kelly, MD
• Kennedy Vision PA
• Christina Kerns, CRNA
• Joseph A Kesselman, O.D.
• Leonard Paul Kessler
• Jessica Ketterer, PH.D.
• Elia Khalaf

• Optometrist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.