DR. KELLY BOUCHER O.D
NPI 1528476207
Optometrist in Oklahoma City, OK

Q: What is Kelly Boucher's NPI number?

The NPI number for Kelly Boucher is 1528476207. It was assigned to this individual provider in the NPPES registry on July 25, 2014.

Q: What is Kelly Boucher's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Boucher was last updated on January 11, 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.

Active since July 25, 2014PECOS EnrolledAccepts Medicare Assignment

4913 W RENO AVE, OKLAHOMA CITY, OK 73127(405) 948-4900(405) 948-4933 Get Directions Write a Review

NPPES record last updated: January 11, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Kelly Boucher O.d NPPES

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

DR. KELLY BOUCHER O.D (NPI 1528476207) is an individual optometrist in Oklahoma City, Oklahoma, licensed in Oklahoma (2802) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, is affiliated with Lawton Indian Hospital, and is a graduate of Indiana University - School Of Optometry (2014).

NPPES Registry Identity

NPI1528476207

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. KELLY BOUCHERCredential: O.D

Location Address4913 W RENO AVEOklahoma City, OK 73127-6339

Mailing Address4913 W Reno AveOklahoma City, OK 73127-6339 · (405) 948-4900 · Fax (405) 948-4933

Phone(405) 948-4900

Fax(405) 948-4933

Sole ProprietorYes

Medical School CMSIndiana University - School Of OptometryGraduated 2014

Enumeration DateJuly 25, 2014

Last NPPES UpdateJanuary 11, 2021

NPPES CertifiedJanuary 11, 2021

✔ NPI 1528476207 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 OK · 2802

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.

4913 W RENO AVE, Oklahoma City, OK 73127

Open in Google Maps ↗

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. Kelly Boucher O.d 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 ID1456571017

PECOS Enrollment IDI20141001002687

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 12

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.

117 services106 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

116 services115 patients

Multiple measurements of eye fluid pressure over an extended time period 92100

This procedure involves recording the pressure inside your eyes at different times throughout the day. By tracking these changes, it can help detect conditions like glaucoma early, which can prevent vision loss. It's painless and non-invasive.

68 services63 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.

53 services43 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.

30 services25 patients

Established patient complete exam of visual system 92014

29 services29 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.

27 services27 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.

26 services23 patients

Imaging of retina 92134

19 services19 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

17 services16 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).

15 services13 patients

Photography of the retina 92250

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lawton Indian Hospital

Acute Care Hospitals · Lawton, OK

OwnershipGovernment - Federal

CMS Certification Number370170

Location1515 Lawrie Tatum RoadLawton, OK 73507 · Comanche County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73127 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

$123.06 typical visit price

range $53.00 – $162.61

Typical copayment $30.76 (range $13.25 – $40.65)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

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.

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

100%60 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

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

CHASE TE IDLEMAN RDH

Dental Hygienist