Matthew Spencer Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2019035034 Issued in MO

Practice address

317 Clarkson Rd
Ellisville, MO 63011-2271

Phone

(636) 391-3937

NPI assigned

Dec 9, 2019

Last updated

Dec 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MO

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimized Eyecare LLCGroup PAC ID 7012345564, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optimized Eyecare, LLC

  • Optometrist
  • Ellisville, MO
  • NPI 1366080632
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1942847918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15976 DOWNALL GREEN DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177320",
            "telephone_number": "314-374-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 CLARKSON RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112271",
            "telephone_number": "636-391-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MATTHEW",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019035034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Christine Kane, D.C.
• Kathryn Schormann LLC (Monarch-therapies)
• Aya Kaziz
• Rachel I Kehr, DDS
• Amy Lynn Kelly, RD
• David Mark Keune, CRNFA
• Mary Richel Kimbrough, DPT
• Megan Klimkewicz, MS
• Jennifer Klinger, O.D.
• Terri L Knutson, PTA

• Optometrist in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.