Individual provider Active NPI

Kelsey L. Gray

  • Optometrist
  • Austin, TX
National Provider Identifier
1275032609
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9892TG Issued in TX
Practice address
4301 W William Cannon Dr
Austin, TX 78749-1473
Phone
(737) 275-5149
NPI assigned
Feb 12, 2018
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9892TG TX Primary

Addresses

Primary practice location

4301 W William Cannon Dr
Austin, TX 78749-1473

Mailing address

5416 Allamanda Dr
Austin, TX 78739-2120
Phone (218) 791-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250428003613 TX Practitioner - Optometry 9133645641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Vision Group, PLLCGroup PAC ID 2062805781, 22 clinicians

Practice addresses (Care Compare)

9600 S Interstate 35
Suite S225
Austin, TX 78748-3889
Phone (512) 291-0876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002635VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Vision Group, PLLC Optometrist CurrentSince Feb 20, 2025 Accepting new patients
Dr Andrew C Kartesz and Assoc PC Optometrist Past Accepting new patients

Locations

1201 Barbara Jordan Blvd
Ste 1480
Austin, TX 78723
Phone (512) 320-1968

9600 S Interstate 35
Ste S225
Austin, TX 78748
Phone (512) 291-0876

Organizations & group practices 2

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1275032609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 ALLAMANDA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787392120",
            "telephone_number": "218-791-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491473",
            "telephone_number": "737-275-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KELSEY",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9892TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.