DR. NICKELLE ANNE KELLOUGH OD
NPI 1669600102
Optometrist in Hollywood, FL

Q: What is Nickelle Kellough's NPI number?

The NPI number for Nickelle Kellough is 1669600102. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Q: What is Nickelle Kellough'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 Nickelle Kellough was last updated on June 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 June 23, 2009PECOS EnrolledAccepts Medicare Assignment

300 S PARK RD STE 300, HOLLYWOOD, FL 33021(954) 925-2740(954) 923-8379 Get Directions Write a Review

NPPES record last updated: June 2, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Nickelle Anne Kellough Od NPPES

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

DR. NICKELLE ANNE KELLOUGH OD (NPI 1669600102) is an individual optometrist in Hollywood, Florida, licensed in Florida (OPC3480) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1669600102

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. NICKELLE ANNE KELLOUGHCredential: OD

Location Address300 S PARK RD STE 300Hollywood, FL 33021-8353

Mailing Address300 S Park Rd Ste 300Hollywood, FL 33021-8353 · (954) 925-2740 · Fax (954) 923-8379

Phone(954) 925-2740

Fax(954) 923-8379

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateJune 23, 2009

Last NPPES UpdateJune 2, 2020

NPPES CertifiedJune 2, 2020

✔ NPI 1669600102 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 FL · OPC3480

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.

300 S PARK RD STE 300, Hollywood, FL 33021

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Accepted Insurance

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

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. Nickelle Anne Kellough Od 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 ID2769472349

PECOS Enrollment IDI20040515000034

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 6

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.

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.

40 services40 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.

36 services33 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

28 services28 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.

20 services20 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).

13 services12 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.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33021 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

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

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 13

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

SCOTT C CARDONE M.D.

Ophthalmology