DR. KELSEY MOORE OD
NPI 1154844017
Optometrist in Plymouth, MN

Active since July 24, 2017PECOS EnrolledAccepts Medicare Assignment
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441(763) 545-8850(763) 544-1257 Get Directions Write a Review

NPPES record last updated: February 5, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 5, 2023, Oct 17, 2022, Apr 23, 2020 and 1 more (4 updates tracked since 2017).

About Dr. Kelsey Moore Od NPPES

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

DR. KELSEY MOORE OD (NPI 1154844017) is an individual optometrist in Plymouth, Minnesota, licensed in Minnesota (3563) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1154844017
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. KELSEY MOORECredential: OD
Location Address10600 OLD COUNTY ROAD 15Plymouth, MN 55441-6200
Mailing Address10600 Old County Road 15Plymouth, MN 55441-6200 · (763) 545-8850 · Fax (763) 544-1257
Fax(763) 544-1257
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 24, 2017
Last NPPES UpdateFebruary 5, 20234 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2023
NPI 1154844017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in MN · 3563
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.

Also ListedOptometrist · PediatricsTaxonomy 152WP0200X · License 3563 (MN)
Also ListedOptometrist · Vision TherapyTaxonomy 152WV0400X · License 3563 (MN)
10600 OLD COUNTY ROAD 15, Plymouth, MN 55441

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelsey Moore Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759711120
PECOS Enrollment IDI20200427000837
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 4

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.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
26 services23 patients
Exam to measure eye deviation and range of motion 92060
This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.
20 services17 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.
19 services17 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55441 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

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.

Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441
Optometrist
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 55441

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 Kelsey Moore's NPI number?

The NPI number for Kelsey Moore is 1154844017. It was assigned to this individual provider in the NPPES registry on July 24, 2017.

Where is Kelsey Moore located?

Kelsey Moore practices at 10600 Old County Road 15, Plymouth, MN 55441. The listed phone number is (763) 545-8850.

What is Kelsey Moore's specialty?

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

Is Kelsey Moore enrolled in Medicare?

Yes. Kelsey Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelsey Moore accept?

Health plans from HealthPartners and Providence Health Plan list Kelsey Moore 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 Kelsey Moore was last updated on February 5, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.