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KENNDY VISION HEALTH CENTER
NPI 1033203963
Optometrist in Plymouth, MN

Active since October 03, 2006
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441(763) 545-8850(763) 544-1257 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 20, 2024, Dec 8, 2022 (2 updates tracked since 2022).

About Kenndy Vision Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNDY VISION HEALTH CENTER (NPI 1033203963) is a healthcare organization registered as an optometrist in Plymouth, Minnesota and active in the NPI registry since October 2006. The organization maintains a secondary practice location in Otsego and lists Anthony Charles Traverse, Doctor, as its authorized official.

NPPES Registry Identity

NPI1033203963
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameKENNEDY VISION HEALTH CENTER, LLC
Location Address10600 OLD COUNTY ROAD 15Plymouth, MN 55441-6210
Mailing Address10600 Old County Road 15Plymouth, MN 55441-6210 · (763) 545-8850 · Fax (763) 544-1257
Phone(763) 545-8850
Fax(763) 544-1257
Organization SubpartNo
Authorized OfficialAnthony Charles TraverseDoctor · (763) 545-8850
Enumeration DateOctober 3, 2006
Last NPPES UpdateAugust 20, 20242 updates tracked since enumeration
NPPES CertifiedAugust 20, 2024
✔ NPI 1033203963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
10600 OLD COUNTY ROAD 15, Plymouth, MN 55441
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Other Names 1

Doing Business AsKenndy Vision Health Center

Secondary Practice Location 1

Location 19075 Quantrelle Ave NE Ste 300Otsego, MN 55330-0139 · Phone (763) 545-8850 · Fax (763) 441-7631

Other Identifiers 7

Medicaid620020600MN
OtherDB1166MN · Railroad Medicare
Other01040808MN · Preferred One
Other2115782MN · Medica
Other417R4KEMN · Bcbs
Other170285MN · Ucare
Other99240MN · Health Partners

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, HealthPartners, Medica.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Kennedy Vision Health Center carries, from the Medicare DMEPOS supplier directory.

Kennedy Vision Health Center

DMEPOS supplier · Plymouth, MNOperated by Kennedy Vision Health Center LLC
✔

Accepts Medicare assignment

Kennedy Vision Health Center agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20683601
Medicare Participant SinceFebruary 1, 2004
Supplier Location10600 Old County Road 15Plymouth, MN 55441
Phone(763) 373-6042
Supplier Specialties
Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KELSEY MOORE OD
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 545-8850
CHASE EDWARD EDER OD
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 452-9381
DR. ANTHONY CHARLES TRAVERSE O.D.
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 545-8850
DR. DAVID LAWRENCE KENNEDY O.D.
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 545-8850
DR. JESSE ROSSOW O.D.
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 545-8850
DR. KIMBERLEY ANNE BUGAJSKI O.D.
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Hennepin County (763) 545-8850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedy Vision Health Center, LLC's NPI number?

The NPI number for Kennedy Vision Health Center, LLC is 1033203963. It was assigned to this organization in the NPPES registry on October 3, 2006. The provider is doing business as Kenndy Vision Health Center.

Where is Kennedy Vision Health Center, LLC located?

Kennedy Vision Health Center, LLC is located at 10600 Old County Road 15, Plymouth, MN 55441. The listed phone number is (763) 545-8850.

What is Kennedy Vision Health Center, LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Kennedy Vision Health Center, LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kennedy Vision Health Center accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Kennedy Vision Health Center, LLC accept?

Health plans from BlueCross BlueShield of Tennessee, HealthPartners and Medica list Kennedy Vision Health Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kennedy Vision Health Center, LLC was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.