Individual provider Active NPI

Kelly P O'Neill, MD

  • Ophthalmology Physician
  • Fairfield, OH
National Provider Identifier
1821067364
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
36-062050 Issued in OH
Practice address
563 Wessel Dr
Fairfield, OH 45014-3668
Phone
(513) 858-6500
Fax
(513) 858-2777
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 36-062050 OH Primary

Addresses

Primary practice location

563 Wessel Dr
Fairfield, OH 45014-3668

Mailing address

5535 Fair LN
Suite C
Cincinnati, OH 45227-3434
Phone (513) 221-5274

Other identifiers 2

IdentifierTypeStateIssuer
180032053OtherOHRAILROAD MEDICARE
0851896MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100528000008 OH Practitioner - Ophthalmology 8426941519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-062050OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cei Physicians PSC, LLC CurrentSince Mar 1, 2020 Accepting new patients
Cei Physicians PSC LLC Ophthalmology CurrentSince Mar 1, 2020 Accepting new patients

Locations

1945 Cei Dr
Blue Ash, OH 45242

563 Wessel Dr
Fairfield, OH 45014
Phone (513) 858-6500

Organizations & group practices 2

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1821067364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 FAIR LN",
            "address_2": "SUITE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273434",
            "telephone_number": "513-221-5274",
            "fax_number": "513-961-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 WESSEL DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143668",
            "telephone_number": "513-858-6500",
            "fax_number": "513-858-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "KELLY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "36-062050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180032053",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0851896",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.