Kelly McCarthy, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3609 Issued in MN

Practice address

4175 Vinewood LN N
Plymouth, MN 55442-2624

Phone

(763) 553-2883

NPI assigned

Jun 9, 2017

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MN

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

Illinois College of Optometry at Chicago, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Point Optical GroupGroup PAC ID 9032491246, 28 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McCarthy Complete Eye Care PLLC

  dba Kelly McCarthy, OD

  • Optometrist
  • St Louis Park, MN
  • NPI 1063125458
  Medicare reassignment NPD Authorized official
• West Point Optical Group

  • Optometrist
  • Novi, MI
  • NPI 1831548890

  MN

  Medicare reassignment Care Compare group NPD
• Brokea Inc.

  dba Pearle Vision

  • Optometrist
  • Maple Grove, MN
  • NPI 1346453735
  Medicare reassignment NPD
• Total Eye Care PA

  • Optometrist
  • Plymouth, MN
  • NPI 1407955420
  Medicare reassignment NPD
• West Point Optical Group

  • Optometrist
  • Ann Arbor, MI
  • NPI 1073983698
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1295264547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 TOMAHAWK RD",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 VINEWOOD LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422624",
            "telephone_number": "763-553-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1473",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxicare Minnesota, Inc
• Christopher Michael McAninch, M.D.
• Tanner James McArdle, MD
• Rachel Mae McCabe
• Ethan McCallum, PHD
• Madison McClement, MSW
• Peyton Kay McClure
• Benton Dale McCone, D.C.
• Jonathan Dean McCue, MD
• Avery Elizabeth McDonnell

• Optometrist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.