Kellen Earl Plomski, OD, MPH

Primary specialty

OptometristTaxonomy code 152W00000X

License

4447ATI Issued in OR

Practice address

12100 SE Stevens CT Ste 106
Clackamas, OR 97086-4707

Phone

(800) 813-2000

NPI assigned

May 1, 2019

Last updated

Jan 14, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellen.plomski@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment Care Compare group NPD
• Murray Scholls Optique Inc

  dba Murray Scholls Vision Center

  • Optometrist
  • Beaverton, OR
  • NPI 1598751802
  Medicare reassignment NPD
• Tigard Vision Center, Inc.

  • Optometrist
  • Tigard, OR
  • NPI 1821083635
  Medicare reassignment NPD
• West Linn Vision Center Inc

  • Optometrist
  • West Linn, OR
  • NPI 1043769227
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1871848457
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1902461361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SE STEVENS CT STE 106",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970864707",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9169 SW Burnham St",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972236105",
            "country_code": "US",
            "telephone_number": "503-639-5115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 8th Ave",
            "address_purpose": "LOCATION",
            "city": "West Linn",
            "state": "OR",
            "postal_code": "970684657",
            "country_code": "US",
            "telephone_number": "503-652-1479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLOMSKI",
        "first_name": "KELLEN",
        "middle_name": "EARL",
        "credential": "OD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4447ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Pitts, BS, CTRS
• Pivot Health Acupuncture
• Katrin Platt, PHARMD
• Daniel L Platter, M.D.
• David Gregory Pleiman, LCSW, MSW
• Joshua Willem Pluim, AUD
• Laura Poellet, MD
• Megan A Polamalu Gordon, CHW
• Carolyn Marie Polansky, MD
• Richard Sanders Polin, MD

• Optometrist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.