Prabhjit Kaur Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5552 Issued in MA

Practice address

121 High St
Boston, MA 02110-2416

Phone

(617) 338-7200

NPI assigned

May 17, 2022

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 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

New England College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lunette Boston, PCGroup PAC ID 0345302709, 4 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.

• Lunette Boston, PC

  • Optometrist
  • Boston, MA
  • NPI 1265613848
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1730826280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HIGH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102416",
            "telephone_number": "617-338-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 HIGH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102416",
            "telephone_number": "617-338-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Memorial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "MA",
            "postal_code": "023684539",
            "country_code": "US",
            "telephone_number": "781-986-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PRABHJIT",
        "middle_name": "KAUR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2023-12-18",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ann Kelly, NP
• Nancy Jean Kelly, OTR/L
• Nicholas James Kelly
• Pamela Kelly, MS RNC PNP
• Paul J Kelly, M.D.
• Rebecca Kelly, FNP-C
• Sarah Kelly
• Sarah E Kelly
• Sean F. Kelly, PH.D
• Sean P Kelly, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.