Kelly Nicole Pouliot, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

S19215586 Issued in MA

Practice address

1504 N Main St
Palmer, MA 01069-1215

Phone

(413) 283-3511

NPI assigned

Jun 5, 2023

Last updated

Jun 5, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Pennsylvania College of Optometry, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Kelly and Velazquez Eye Center PCGroup PAC ID 3274603915, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpouliot@directaddress.net

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.

• Kelly and Velazquez Eye Center PC

  • Ophthalmology Physician
  • Palmer, MA
  • NPI 1306847462
  Medicare reassignment Care Compare group NPD
• Kelly and Velazquez Eye Center PC

  • Durable Medical Equipment & Medical Supplies
  • Ludlow, MA
  • NPI 1063558070
  NPD (past)

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1437843398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HOLLYWOOD ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010753012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N MAIN ST",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691215",
            "telephone_number": "413-283-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "S19215586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carene Pettinger, PA-C
• Kayli Paige Philibotte
• James Phillips, OPTICIAN
• Brian Pickell, PSY.D
• Jessica Marie Potvin, CCLS
• Robin M Powell, LICSW
• Joanna M. Preibisz, M.D.
• Prescription Foot Balance, Inc.
• Proactive Billing Solutions, LLC
• Laurie Provost, MSN FNP-BC

• Optometrist in Palmer, MA
• Providers in Palmer, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.