Kelsey Jordan Palmer, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

009499 Issued in NY

Practice address

18431 N 91St Ave Ste 1
Peoria, AZ 85382-0817

Phone

(623) 393-8324

NPI assigned

Nov 29, 2021

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, AZ, FL, MA, ID, MD, DC, CO, UT, NH10 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 10

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 62)

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ecp_cecaz

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.

• Family First Vision Care Arizona PLLC

  dba Pearle Vision

  • Optometrist
  • Phoenix, AZ
  • NPI 1639875826
  Medicare reassignment NPD
• John H McDougall OD Arizona PC

  dba 20/20 Image Eye Centers

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  Medicare reassignment NPD
• Nationwide Optometry P.C.

  dba Nationwide Vision

  • Optometrist
  • Tempe, AZ
  • NPI 1326472945
  Medicare reassignment NPD
• Abba Eye Care PC

  • Optometrist
  • Colorado Springs, CO
  • NPI 1952301129
  Medicare reassignment NPD
• Bass River Optical, Inc.

  dba Bass River Optometrics

  • Optometrist
  • Orleans, MA
  • NPI 1922155258
  Medicare reassignment NPD
• CVG Optometry, LLC

  • Optometrist
  • Rochester, NY
  • NPI 1194959486
  Medicare reassignment NPD
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Foley Vision Center LLC

  • Optometrist
  • Amesbury, MA
  • NPI 1063908960
  Medicare reassignment NPD
• Myeyedr Optometry of Colorado PC

  dba MyEyeDr.

  • Optometrist
  • Parker, CO
  • NPI 1174170526
  Medicare reassignment NPD
• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr

  • Optometrist
  • Waldorf, MD
  • NPI 1609204437
  Medicare reassignment NPD
• Myeyedr Optometry of Massachusetts P C

  dba MyEyeDr.

  • Optometrist
  • Amherst, MA
  • NPI 1124534946
  Medicare reassignment NPD

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1992462725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE STE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-393-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE STE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-393-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KELSEY",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2920",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5539",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002579",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100623",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I5-0000005",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1058",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "TPOP102",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003933",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "13429536-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jadranka Todor Pajazetovic, RPH
• Jeffrey L Pakula, D.O.
• Paladino Physical Therapy PLLC
• Jason Paladino, MPT
• Colleen Palko, L.M.T.
• Palo Verde Family Medicine PLLC
• Palo Verde Hematology Oncology LTD
• Bol Gach Pan
• Kaveh Panahi, DPM
• Panda Medical Associates, LLC

• Optometrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.