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KENNEDY VISION PA
NPI 1104167345
Optometrist in Pembroke Pines, FL

Active since March 13, 2013
18503 PINES BLVD STE 205, PEMBROKE PINES, FL 33029(954) 430-8330(954) 430-3638 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 28, 2025, Jun 18, 2020 (2 updates tracked since 2020).

About Kennedy Vision Pa NPPES

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

KENNEDY VISION PA (NPI 1104167345), doing business as The Family Eye Site, is a healthcare organization registered as an optometrist in Pembroke Pines, Florida and active in the NPI registry since March 2013. The organization lists Caleb Joseph Kennedy, Optometrist/owner, as its authorized official.

NPPES Registry Identity

NPI1104167345
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameKENNEDY VISION PA
Location Address18503 PINES BLVD STE 205Pembroke Pines, FL 33029-1405
Mailing Address18503 Pines Blvd Ste 205Pembroke Pines, FL 33029-1405 · (954) 430-8330 · Fax (954) 430-3638
Phone(954) 430-8330
Fax(954) 430-3638
Organization SubpartNo
Authorized OfficialCaleb Joseph KennedyOptometrist/owner · (954) 430-8330
Enumeration DateMarch 13, 2013
Last NPPES UpdateMay 28, 20252 updates tracked since enumeration
NPPES CertifiedMay 28, 2025
✔ NPI 1104167345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in FL · OPC4146
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.
18503 PINES BLVD STE 205, Pembroke Pines, FL 33029
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Other Names 1

Doing Business AsThe Family Eye Site

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 Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kennedy Vision Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kennedy Vision PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Caleb Kennedy, O.D.
Optometry
NPI 1205064334
18503 PINES BLVD STE 205
Pembroke Pines, FL 33029
(954) 430-8330
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 PA's NPI number?

The NPI number for Kennedy Vision PA is 1104167345. It was assigned to this organization in the NPPES registry on March 13, 2013. The provider is doing business as The Family Eye Site.

Where is Kennedy Vision PA located?

Kennedy Vision PA is located at 18503 Pines Blvd Ste 205, Pembroke Pines, FL 33029. The listed phone number is (954) 430-8330.

What is Kennedy Vision PA's specialty?

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

Is Kennedy Vision PA enrolled in Medicare?

Yes. Kennedy Vision PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kennedy Vision PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Kennedy Vision PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kennedy Vision PA accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee and 2 other insurers list Kennedy Vision PA 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 PA was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.