Kelly F Grosdidier, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1427 Issued in KS

Practice address

8300 College Blvd.
Suite 201
Overland Park, KS 66210

Phone

(913) 491-3330

Fax

(913) 491-9650

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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 KS

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

University of Houston - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Durrie Vision P aGroup PAC ID 9830157635, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Durrie Vision, PA

  • Specialist
  • Overland Park, KS
  • NPI 1932434982

  Optometrist

  Medicare reassignment Care Compare group NPD
• Refractive Cataract Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Overland Park, KS
  • NPI 1417591165
  NPD
• Bethany Eye Center, LLC

  • Optometrist
  • Bethany, MO
  • NPI 1245278753
  NPD (past)
• Moyes Eye Center, P.C.

  • Specialist
  • Kansas City, MO
  • NPI 1700826229
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1568466985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 COLLEGE BLVD.",
            "address_2": "SUITE 201",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-491-3330",
            "fax_number": "913-491-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 COLLEGE BLVD.",
            "address_2": "SUITE 201",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-491-3330",
            "fax_number": "913-491-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSDIDIER",
        "first_name": "KELLY",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Arik Gripentrog, CCC-SLP
• Chris Grisafe-Pont
• John Grisham, M.D.
• Adam Grooms, M.D.
• Jamie Michelle Groover, RBT
• Jeremy Alexander Gross
• Lucilene A. Gross, BCBA
• Harvey M Grossman, MD
• Kara Grossman
• Kristina Grove, APRN

• Optometrist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.