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CHRISTINA TAN MICHELLE KENNEDY O.D.
NPI 1154480911
Optometrist in Fort Wayne, IN

Active since December 07, 2006PECOS Enrolled
86.86/100
CMS Quality Rating
6709 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 432-8409(260) 484-0616 Get Directions Write a Review

NPPES record last updated: May 3, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Christina Tan Michelle Kennedy O.d. NPPES

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

CHRISTINA TAN MICHELLE KENNEDY O.D. (NPI 1154480911) is an individual optometrist in Fort Wayne, Indiana, licensed in Indiana (18003936AB) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1154480911
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameCHRISTINA TAN MICHELLE KENNEDYCredential: O.D.
Location Address6709 W JEFFERSON BLVDFort Wayne, IN 46804-6209
Mailing Address3060 Franklin TerJohnson City, TN 37604-4123 · (423) 282-4221 · Fax (423) 282-5124
Phone(260) 432-8409
Fax(260) 484-0616
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateDecember 7, 2006
Last NPPES UpdateMay 3, 2019
✔ NPI 1154480911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in IN · 18003936AB✔ Licensed in GA · OPT002409✔ Licensed in MI · 4901004315✔ Licensed in TN · 2916
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.
6709 W JEFFERSON BLVD, Fort Wayne, IN 46804
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Christina Tan Michelle Kennedy O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981979358
PECOS Enrollment IDI20171011001248
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
125 services120 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
76 services64 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
62 services57 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
43 services40 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
34 services33 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
23 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost56.22

Other Providers at the Same Location NPPES 2

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

LONGE ENTERPRISES CORP
Eyewear Supplier
6709 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-8409
C J PATALUCH OD PC
Optometrist
6709 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (765) 617-1890

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 Christina Kennedy's NPI number?

The NPI number for Christina Kennedy is 1154480911. It was assigned to this individual provider in the NPPES registry on December 7, 2006.

Where is Christina Kennedy located?

Christina Kennedy practices at 6709 W Jefferson Blvd, Fort Wayne, IN 46804. The listed phone number is (260) 432-8409.

What is Christina Kennedy's specialty?

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

Is Christina Kennedy enrolled in Medicare?

Yes. Christina Kennedy is registered in the Medicare PECOS enrollment system.

What insurance does Christina Kennedy accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Christina Kennedy 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 Christina Kennedy was last updated on May 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.