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KIM MY KELLY OD
NPI 1629963459
Optometrist in Chula Vista, CA

Active since June 11, 2025PECOS Enrolled
342 F ST, CHULA VISTA, CA 91910(619) 422-1471 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kim My Kelly Od NPPES

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

KIM MY KELLY OD (NPI 1629963459) is an individual optometrist in Chula Vista, California, licensed in California (36002) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2025).

NPPES Registry Identity

NPI1629963459
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKIM MY KELLYCredential: OD
Location Address342 F STChula Vista, CA 91910-2625
Mailing Address5055 Summerhill DrOceanside, CA 92057-6921 · (760) 682-8073
Phone(619) 422-1471
Sole ProprietorNo
Medical School CMSSouthern California College Of OptometryGraduated 2025
Enumeration DateJune 11, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1629963459 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 · 36002
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.
342 F ST, Chula Vista, CA 91910
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kim My Kelly Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204330491
PECOS Enrollment IDI20250919002189
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 91910 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
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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 11

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

DR. DUANE M BRYANT MD
Ophthalmology
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
DAVID IERSTON-BROWN
Optometrist
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
MARIA E CASTILLEJOS M.D.
Ophthalmology
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
STANLEY ROY PLUCINIK OD
Optometrist
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
ALEXANDRA G CASTILLEJOS ELLENTHAL MD
Ophthalmology
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
DR. ALEXANDER ZABANEH M.D.
Ophthalmology
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
DR. KETAN BAKRIWALA O.D.
Optometrist
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471
DAVID CASTILLEJOS M.D.
Ophthalmology
342 F ST
CHULA VISTA, CA 91910
San Diego County (619) 422-1471

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 Kim Kelly's NPI number?

The NPI number for Kim Kelly is 1629963459. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Kim Kelly located?

Kim Kelly practices at 342 F St, Chula Vista, CA 91910. The listed phone number is (619) 422-1471.

What is Kim Kelly's specialty?

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

Is Kim Kelly enrolled in Medicare?

Yes. Kim Kelly is registered in the Medicare PECOS enrollment system.

What insurance does Kim Kelly accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Kim Kelly 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 Kim Kelly was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.