KELSEY JORDAN OD
NPI 1619406154
Optometrist in Boston, MA
About Kelsey Jordan Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELSEY JORDAN OD (NPI 1619406154) is an individual optometrist in Boston, Massachusetts, licensed in Massachusetts (5239) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lebanon.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelsey Jordan Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Kelsey Jordan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hampstead, NH 03841
- Reassigned Medicare billing, New Hampshire enrollment
- 2,620 clinicians in this Medicare group
Keene, NH 03431
- Reassigned Medicare billing, New Hampshire enrollment
- 2,999 clinicians in this Medicare group
White River Junction, VT 05001
- Reassigned Medicare billing, Vermont enrollment
- 7 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 02130 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BOSTON, MA 02130
BOSTON, MA 02130
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 Jordan's NPI number?
The NPI number for Kelsey Jordan is 1619406154. It was assigned to this individual provider in the NPPES registry on June 8, 2017.
Where is Kelsey Jordan located?
Kelsey Jordan practices at 150 S Huntington Ave, Boston, MA 02130. The listed phone number is (857) 364-6669.
What is Kelsey Jordan's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Kelsey Jordan enrolled in Medicare?
Yes. Kelsey Jordan is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelsey Jordan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelsey Jordan reassigns Medicare benefits to 3 organizations: Mary Hitchcock Memorial Hospital (Hampstead, NH), Dartmouth-Hitchcock Clinic (Keene, NH) and White River Family Eyecare, PC (White River Junction, VT). 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 Kelsey Jordan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelsey Jordan was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kelsey Jordan, OD · NPI 1619406154
Optometrist provider in Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since June 8, 2017.
## Identity
- **NPI:** 1619406154 (Entity type: Individual)
- **Enumerated:** June 8, 2017
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 5239 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 150 S HUNTINGTON AVE, Boston, MA 02130-4817
- **Phone:** (857) 364-6669
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Mary Hitchcock Memorial Hospital (NPI 1699584219, Hampstead, NH); Dartmouth-Hitchcock Clinic (NPI 1174176861, Keene, NH); White River Family Eyecare, PC (NPI 1104878206, White River Junction, VT) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1619406154) · Data from the CMS NPPES public registry.