DR. NICKELLE ANNE KELLOUGH OD
NPI 1669600102
Optometrist in Hollywood, FL
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Nickelle Kellough reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jacksonville, FL 32223
- Reassigned Medicare billing, Florida enrollment
- 321 clinicians in this Medicare group
Jacksonville, FL 32223
- Reassigned Medicare billing, Florida enrollment
- 30 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.
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.
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.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 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.
Where is Nickelle Kellough located?
Nickelle Kellough practices at 300 S Park Rd Ste 300, Hollywood, FL 33021. The listed phone number is (954) 925-2740.
What is Nickelle Kellough's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Nickelle Kellough enrolled in Medicare?
Yes. Nickelle Kellough 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.
Which organizations bill Medicare for Nickelle Kellough's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nickelle Kellough reassigns Medicare benefits to 2 organizations: North Florida Surgeons, PA (Jacksonville, FL) and Dr. Ted Brink And Associates PA (Jacksonville, FL). 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 Nickelle Kellough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nickelle Kellough accept?
Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Cigna HealthCare of Florida, Inc., Cigna Healthcare and Florida Blue (BlueCross BlueShield FL) and 5 other insurers list Nickelle Kellough 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 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.
# Dr. Nickelle Anne Kellough, OD · NPI 1669600102
Optometrist provider in Hollywood, Florida. Individual provider, active in the CMS NPPES registry since June 23, 2009.
## Identity
- **NPI:** 1669600102 (Entity type: Individual)
- **Enumerated:** June 23, 2009
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPC3480 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 300 S PARK RD STE 300, Hollywood, FL 33021-8353
- **Phone:** (954) 925-2740 · **Fax:** (954) 923-8379
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): North Florida Surgeons, PA (NPI 1912953290, Jacksonville, FL); Dr. Ted Brink And Associates PA (NPI 1427138650, Jacksonville, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2000
## Record status
- **NPPES last updated:** June 2, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1669600102) · Data from the CMS NPPES public registry.