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DR. MALLORY ADELE KENNEDY O.D.
NPI 1538511837
Optometrist in Riverside, CA

Active since July 11, 2016PECOS EnrolledAccepts Medicare Assignment
7379 INDIANA AVE, RIVERSIDE, CA 92504(951) 684-7822(951) 977-8075 Get Directions Write a Review

NPPES record last updated: August 6, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 6, 2021, Jul 11, 2016 (2 updates tracked since 2016).

About Dr. Mallory Adele Kennedy O.d. NPPES

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

DR. MALLORY ADELE KENNEDY O.D. (NPI 1538511837) is an individual optometrist in Riverside, California, licensed in California (33508TLG) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1538511837
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. MALLORY ADELE KENNEDYCredential: O.D.
Location Address7379 INDIANA AVERiverside, CA 92504-4547
Mailing Address7379 Indiana AveRiverside, CA 92504-4547 · (951) 684-7822 · Fax (951) 977-8075
Phone(951) 684-7822
Fax(951) 977-8075
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 11, 2016
Last NPPES UpdateAugust 6, 20212 updates tracked since enumeration
NPPES CertifiedAugust 6, 2021
✔ NPI 1538511837 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 · 33508TLG
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.
7379 INDIANA AVE, Riverside, CA 92504
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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 and accepts Medicare assignment

Dr. Mallory Adele Kennedy 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 ID3779638184
PECOS Enrollment IDI20240503001099
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92504 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
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
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 7

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

DR. CHERYL MARIE EVERITT O.D.
Optometrist
7379 INDIANA AVE, SUITE 101
RIVERSIDE, CA 92504
Riverside County (951) 684-7822
PHUONG NGUYET PHUN
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (951) 684-7822
20/20 VISION ASSOCIATES OPTOMETRY, INC.
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (951) 684-7822
AHMAD WAHEED AHMADZADA OD
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (951) 684-7822
SCOTT NGUYEN OD
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (951) 477-4732
LUBNA OZA
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (512) 529-0863
FOURTH OPTOMETRIC CARE OF CALIFORNIA
Optometrist
7379 INDIANA AVE
RIVERSIDE, CA 92504
Riverside County (951) 684-7822

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 Mallory Kennedy's NPI number?

The NPI number for Mallory Kennedy is 1538511837. It was assigned to this individual provider in the NPPES registry on July 11, 2016.

Where is Mallory Kennedy located?

Mallory Kennedy practices at 7379 Indiana Ave, Riverside, CA 92504. The listed phone number is (951) 684-7822.

What is Mallory Kennedy's specialty?

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

Is Mallory Kennedy enrolled in Medicare?

Yes. Mallory Kennedy 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.

When was this NPI record last updated?

The NPPES record for Mallory Kennedy was last updated on August 6, 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.