Michelle Ketcher, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6209 Issued in FL

Practice address

9375 66TH St N
Pinellas Park, FL 33782-4418

Phone

(727) 541-4469

NPI assigned

Feb 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Eye Institute PAGroup PAC ID 8224931993, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (1 of 2)

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mketcher@eapinellas.intellechartdirect.net

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.

• Southeast Eye Institute, PA

  • Ophthalmology Physician
  • Pinellas Park, FL
  • NPI 1073625331

  FL, Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1942908512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9375 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9375 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824418",
            "telephone_number": "727-541-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1915 34th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337133605",
            "country_code": "US",
            "telephone_number": "727-485-8146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHER",
        "first_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15862567",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mketcher@eapinellas.intellechartdirect.net",
            "affiliation": "Y",
            "affiliationName": "Southeast Eye Institute, PA",
            "address_1": "1915 34th St N",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337133605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christan Williams Kelley
• Kimberly Kelley, PHARM D
• Anita Marie Kelly, LMHC, CAP
• Sarah Kathleen Kelly, D.C.
• Tamara J Kennedy, PT
• Chloe Ketchum
• Jane E Kienle, MD
• Thomas E Kiernan, ARNP
• Kim B. Powers, D.O., P.a.
• Zak A. Kimmett, DPT

• All providers in Pinellas Park, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.