MR. KELLY MCCARTHY OD
NPI 1295264547
Optometrist in Plymouth, MN
About Mr. Kelly Mccarthy Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KELLY MCCARTHY OD (NPI 1295264547) is an individual optometrist in Plymouth, Minnesota, licensed in Minnesota (3609) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2017).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Kelly Mccarthy 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.
Medicare Billing Reassignments
4Medicare enrollment records show Kelly Mccarthy reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Plymouth, MN 55442
- Reassigned Medicare billing, Minnesota enrollment
- 4 clinicians in this Medicare group
Maple Grove, MN 55369
- Reassigned Medicare billing, Minnesota enrollment
- 17 clinicians in this Medicare group
St Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
Novi, MI 48375
- Reassigned Medicare billing, Minnesota enrollment
- 9 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55442 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kelly Mccarthy's NPI number?
The NPI number for Kelly Mccarthy is 1295264547. It was assigned to this individual provider in the NPPES registry on June 9, 2017.
Where is Kelly Mccarthy located?
Kelly Mccarthy practices at 4175 Vinewood Ln N, Plymouth, MN 55442. The listed phone number is (763) 553-2883.
What is Kelly Mccarthy's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Kelly Mccarthy enrolled in Medicare?
Yes. Kelly Mccarthy 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.
Which organizations bill Medicare for Kelly Mccarthy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Mccarthy reassigns Medicare benefits to 4 organizations: Total Eye Care PA (Plymouth, MN), Brokea Inc. (Maple Grove, MN), Mccarthy Complete Eye Care PLLC (St Louis Park, MN) and West Point Optical Group (Novi, MI). Each 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 Kelly Mccarthy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Mccarthy accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Kelly Mccarthy 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 Kelly Mccarthy was last updated on August 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mr. Kelly Mccarthy, OD · NPI 1295264547
Optometrist provider in Plymouth, Minnesota. Individual provider, active in the CMS NPPES registry since June 9, 2017.
## Identity
- **NPI:** 1295264547 (Entity type: Individual)
- **Enumerated:** June 9, 2017
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 3609 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4175 VINEWOOD LN N, Plymouth, MN 55442-2624
- **Phone:** (763) 553-2883
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Total Eye Care PA (NPI 1407955420, Plymouth, MN); Brokea Inc. (NPI 1346453735, Maple Grove, MN); Mccarthy Complete Eye Care PLLC (NPI 1063125458, St Louis Park, MN); West Point Optical Group (NPI 1831548890, Novi, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Illinois College Of Optometry At Chicago, class of 2017
## Record status
- **NPPES last updated:** August 10, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1295264547) · Data from the CMS NPPES public registry.