Kim My Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

36002 Issued in CA

Practice address

342 F St
Chula Vista, CA 91910-2625

Phone

(619) 422-1471

NPI assigned

Jun 11, 2025

Sex

Female

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 CA

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

Southern California College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.kelly@uprisedirect.com

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.

• Total Vision PC

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment Care Compare group
• Castillejos Eye Institute Medical Group

  • Ophthalmology Physician
  • Chula Vista, CA
  • NPI 1841377660
  Medicare reassignment NPD
• Castillejos Eye Institute Medical Group

  • Ophthalmology Physician
  • Chula Vista, CA
  • NPI 1982775672

  Optometrist

  NPD

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1629963459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 SUMMERHILL DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920576921",
            "telephone_number": "760-682-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 F ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102625",
            "telephone_number": "619-422-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KIM",
        "middle_name": "MY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "36002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyshira Monee Keeling
• Ellen Mae Kehoe, BCBA
• Keith J Biscotti Chiropractic Inc
• Christina M Kelley, DNP, AGCNS-BC
• Rachel Kelley, FNP-BC
• Walter Kelly, H.I.S.
• Kelsey Barbieri, Licensed Clinical Social Worker, a Professional Corp
• Jordan Dean Wingfield Keltner
• Brian Anthony Kendrick, LCSW
• Gabrielle Kennedy, OTD, OTR/L

• Optometrist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.