Individual provider Active NPI

Kelly Raies, O.D.

  • Optometrist
  • Portsmouth, OH
National Provider Identifier
1831237882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4011 Issued in OH
Practice address
1915 Scioto TRL
Portsmouth, OH 45662-2843
Phone
(740) 354-2821
Fax
(740) 354-6162
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4011 OH Primary

Addresses

Primary practice location

1915 Scioto TRL
Portsmouth, OH 45662-2843

Mailing address

1915 Scioto TRL
Portsmouth, OH 45662-2843
Phone (740) 354-2821

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151228001683 OH Practitioner - Optometry 8022039494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portsmouth Vision Center, LTDGroup PAC ID 5698796068, 6 clinicians

Practice addresses (Care Compare)

1915 Scioto TRL
Portsmouth, OH 45662-2874
Phone (740) 354-2821

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4011OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wheelersburg Vision Center LLC Optometrist CurrentSince Sep 24, 2020 Accepting new patients
Portsmouth Vision Center, LTD Optometrist CurrentSince Nov 10, 2015 Accepting new patients

Locations

1915 Scioto Trl
Portsmouth, OH 45662
Phone (740) 354-2821

536 Bulwer St
Wheelersburg, OH 45694
Phone (740) 574-1903

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831237882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 SCIOTO TRL",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622843",
            "telephone_number": "740-354-2821",
            "fax_number": "740-354-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 SCIOTO TRL",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622843",
            "telephone_number": "740-354-2821",
            "fax_number": "740-354-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIES",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.