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KELLIE-ANNE CHIEMI ISHII-KIM OD
NPI 1710465372
Optometrist in San Dimas, CA

Active since August 04, 2018PECOS EnrolledAccepts Medicare Assignment
83.08/100
CMS Quality Rating
425 W BONITA AVE STE 110B, SAN DIMAS, CA 91773(909) 394-0462 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Mar 1, 2023, Aug 4, 2018 (3 updates tracked since 2018).

About Kellie-anne Chiemi Ishii-kim Od NPPES

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

KELLIE-ANNE CHIEMI ISHII-KIM OD (NPI 1710465372) is an individual optometrist in San Dimas, California, licensed in California (35068) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2018).

NPPES Registry Identity

NPI1710465372
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKELLIE-ANNE CHIEMI ISHII-KIMCredential: OD
Location Address425 W BONITA AVE STE 110BSan Dimas, CA 91773-2543
Mailing Address3621 Woodpecker StBrea, CA 92823-1064
Phone(909) 394-0462
Sole ProprietorNo
Medical School CMSSouthern California College Of OptometryGraduated 2018
Enumeration DateAugust 4, 2018
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedMarch 7, 2023
✔ NPI 1710465372 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 · 35068
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.
425 W BONITA AVE STE 110B, San Dimas, CA 91773
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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 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

Kellie-anne Chiemi Ishii-kim 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 ID1153674577
PECOS Enrollment IDI20230516003031
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 91773 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.08/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality46.16
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

DR. ELIZABETH M TSAY O.D.
Optometrist
425 W BONITA AVE STE 110B
SAN DIMAS, CA 91773
Los Angeles County (909) 394-0462
VIONE WONG OD
Optometrist
425 W BONITA AVE STE 110B
SAN DIMAS, CA 91773
Los Angeles County (909) 394-0462
JULIE LAM O.D.
Optometrist
425 W BONITA AVE STE 110B
SAN DIMAS, CA 91773
Los Angeles County (909) 394-0462
DR. ASHLEY NAKAMURA O.D.
Optometrist
425 W BONITA AVE STE 110B
SAN DIMAS, CA 91773
Los Angeles County (909) 394-0462

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 Kellie-anne Ishii-kim's NPI number?

The NPI number for Kellie-anne Ishii-kim is 1710465372. It was assigned to this individual provider in the NPPES registry on August 4, 2018.

Where is Kellie-anne Ishii-kim located?

Kellie-anne Ishii-kim practices at 425 W Bonita Ave Ste 110B, San Dimas, CA 91773. The listed phone number is (909) 394-0462.

What is Kellie-anne Ishii-kim's specialty?

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

Is Kellie-anne Ishii-kim enrolled in Medicare?

Yes. Kellie-anne Ishii-kim 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.

What insurance does Kellie-anne Ishii-kim accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Kellie-anne Ishii-kim 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 Kellie-anne Ishii-kim was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.