Kelsey Dedomenico, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTG00752 Issued in RI

Practice address

99 E Main Rd
Middletown, RI 02842-4983

Phone

(401) 848-7400

NPI assigned

Nov 9, 2023

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 RI, MA2 enrollments

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 2

Specialty

Optometry

Education

New England College of Optometry, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Rhode Island Optometrics LLCGroup PAC ID 5799026662, 8 clinicians

Mass Optometric Associates, PLLCGroup PAC ID 0648362442, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mass Optometric Associates, PLLC

  • Optometrist
  • Malden, MA
  • NPI 1063610194
  Medicare reassignment Care Compare group NPD
• Rhode Island Optometrics, LLC

  • Optometrist
  • Cranston, RI
  • NPI 1275024135
  Medicare reassignment Care Compare group
• Mass Optometric Associates, PLLC

  • Optometrist
  • Attleboro, MA
  • NPI 1972059723
  NPD

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1861266967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SACHEM ST",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018216403",
            "telephone_number": "978-821-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E MAIN RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028424983",
            "telephone_number": "401-848-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDOMENICO",
        "first_name": "KELSEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramin R Davoudi, MD
• Cynthia Ann Dawson, RN
• Catherine Anne Day, LMHC-A
• Caitlin De Hoyos, DPT
• Nicole Decristoforo
• Margaret Degregorio, LICSW
• Marianne F Delguercio, NP
• Paul V Delguercio, MD
• Gail Demarco, RN
• Carissa Marie Demello, LICSW

• Optometrist in Middletown, RI
• Providers in Middletown, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.