Kaitlyn S Keller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010544 Issued in IL

Practice address

300 Memorial Dr
Crystal Lake, IL 60014-6278

Phone

(815) 459-7110

Fax

(815) 459-2889

NPI assigned

Jun 13, 2012

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Illinois College of Optometry at Chicago, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifetime Vision and Contact Lens Center LTDGroup PAC ID 1557421757, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.75 of 100Reported as group

Quality

63.51

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kskeller@direct.revolutionehr.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.

• Lifetime Vision & Contact Lens Center, LTD.

  • Optometrist
  • Crystal Lake, IL
  • NPI 1679625966
  Medicare reassignment Care Compare group NPD
• Lifetime Vision and Contact Lens Center

  • Optometrist
  • Crystal Lake, IL
  • NPI 1932522273
  NPD

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1760744833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR STE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146273",
            "telephone_number": "815-459-7110",
            "fax_number": "815-459-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146278",
            "telephone_number": "815-459-7110",
            "fax_number": "815-459-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KAITLYN",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406010544",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "502720063",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maurine Lynn Kaskel, LCSW
• Anna Kastanas, APN
• Kathleen a. Schroeder DDS
• Vasanth Kattalai Kailasam, MD
• Lauren Tracy Kell, LPC
• Lindsay Amanda Kellner, LCSW
• Danielle Irene Kelly, NP
• Rebekah C Kelly, RD
• Kendal Physical Therapy LLC
• Wesley Kennedy, LSW

• Optometrist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.