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DR. KELSEY H JEWETT O.D.
NPI 1396880415
Optometrist in Shasta Lake, CA

Active since February 20, 2007PECOS Enrolled
4626 SHASTA DAM BLVD, SHASTA LAKE, CA 96019(530) 275-0866 Get Directions Write a Review

NPPES record last updated: December 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kelsey H Jewett O.d. NPPES

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

DR. KELSEY H JEWETT O.D. (NPI 1396880415) is an individual optometrist in Shasta Lake, California, licensed in California (5883T) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396880415
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. KELSEY H JEWETTCredential: O.D.
Location Address4626 SHASTA DAM BLVDShasta Lake, CA 96019-9414
Mailing Address4767 Rocky Ridge CtRedding, CA 96001-4005 · (530) 209-3315
Phone(530) 275-0866
Sole ProprietorYes
Enumeration DateFebruary 20, 2007
Last NPPES UpdateDecember 12, 2025
NPPES CertifiedDecember 12, 2025
✔ NPI 1396880415 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 CA · 5883T
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.
4626 SHASTA DAM BLVD, Shasta Lake, CA 96019
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelsey H Jewett O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 2

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.

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.
65 services65 patients
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.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96019 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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 2

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

DR. RICHARD ARTHUR MARTIN O.D.
Optometrist (Low Vision Rehabilitation)
4626 SHASTA DAM BLVD
SHASTA LAKE, CA 96019
Shasta County (530) 275-0866
DENISE DILTS-WALDROP
Technician/Technologist (Optician)
4626 SHASTA DAM BLVD
SHASTA LAKE, CA 96019
Shasta County (530) 275-0866

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 Jewett's NPI number?

The NPI number for Kelsey Jewett is 1396880415. It was assigned to this individual provider in the NPPES registry on February 20, 2007.

Where is Kelsey Jewett located?

Kelsey Jewett practices at 4626 Shasta Dam Blvd, Shasta Lake, CA 96019. The listed phone number is (530) 275-0866.

What is Kelsey Jewett's specialty?

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

Is Kelsey Jewett enrolled in Medicare?

Yes. Kelsey Jewett is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelsey Jewett was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.