Individual provider Active NPI

Kelly Huynh, OD

  • Optometrist
  • Lexington, KY
National Provider Identifier
1528796760
Registry record updated Aug 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35169 Issued in CA
Practice address
2250 Leestown Rd
Lexington, KY 40511-1052
Phone
(859) 233-4511
NPI assigned
Aug 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 35169 CA Primary

Addresses

Primary practice location

2250 Leestown Rd
Lexington, KY 40511-1052

Mailing address

2380 Lake Park Rd Apt 914
Lexington, KY 40502-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20230712001052 DC Practitioner - Optometry 0941660757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James W Mattern OD, PLLCGroup PAC ID 6800262833, 6 clinicians

Practice addresses (Care Compare)

3025 Hamaker CT
Suite 101
Fairfax, VA 22031-2229
Phone (703) 876-9630

Merit-based Incentive Payment System (MIPS)

Final score
90.53 of 100Reported as group
Quality
92.86
Improvement activities
40
Cost
77.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35169CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
James W Mattern OD, PLLC Optometrist CurrentSince Jul 10, 2023 Accepting new patients

Locations

3025 Hamaker Ct
Ste 101
Fairfax, VA 22031
Phone (703) 876-9630

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1528796760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 LAKE PARK RD APT 914",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405026601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111052",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "KELLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-14",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.