Individual provider Active NPI

Kelsey Tricia Engelman, OD

  • Optometrist
  • Flint, MI
National Provider Identifier
1467075929
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005474 Issued in MI
Practice address
4499 Town Center Pkwy
Flint, MI 48532-3425
Phone
(810) 733-7111
NPI assigned
May 19, 2020
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005474 MI Primary

Addresses

Primary practice location

4499 Town Center Pkwy
Flint, MI 48532-3425

Mailing address

4499 Town Center Pkwy
Flint, MI 48532-3425
Phone (810) 733-7111

Other names 1

  • Dr. Kelsey Tricia Binggeli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200715003027 MI Practitioner - Optometry 2961826581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mei Operations, PLLCGroup PAC ID 2860436318, 17 clinicians

Practice addresses (Care Compare)

4499 Town Ctr Pkwy
Flint, MI 48532-3425
Phone (810) 733-7111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005474MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mei Operations, PLLC CurrentSince Jul 6, 2020 Accepting new patients

Locations

4499 Town Center Pkwy
Flint, MI 48532
Phone (810) 733-7111

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": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1467075929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 TOWN CENTER PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323425",
            "telephone_number": "810-733-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 TOWN CENTER PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323425",
            "telephone_number": "810-733-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMAN",
        "first_name": "KELSEY",
        "middle_name": "TRICIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "BINGGELI",
            "middle_name": "TRICIA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.