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RANDY MATHEW KELLY OD
NPI 1770537896
Optometrist in Edina, MN

Active since May 22, 2006PECOS EnrolledAccepts Medicare Assignment
2195 SOUTHDALE CTR, EDINA, MN 55435(952) 920-8770 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randy Mathew Kelly Od NPPES

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

RANDY MATHEW KELLY OD (NPI 1770537896) is an individual optometrist in Edina, Minnesota, licensed in Minnesota (2917) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (2003).

NPPES Registry Identity

NPI1770537896
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameRANDY MATHEW KELLYCredential: OD
Location Address2195 SOUTHDALE CTREdina, MN 55435-7065
Mailing Address7962 Sunwood Dr. Nw, Suite 300Ramsey, MN 55303 · (763) 213-7940
Phone(952) 920-8770
Sole ProprietorYes
Medical School CMSPacific University - College Of OptometryGraduated 2003
Enumeration DateMay 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1770537896 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 MN · 2917
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.
2195 SOUTHDALE CTR, Edina, MN 55435
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Other Identifiers 1

Medicare UPINU97933MN

Accepted Insurance

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

Randy Mathew Kelly 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 ID6507751179
PECOS Enrollment IDI20040220001044
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 2

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.

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.
25 services25 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.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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 4

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

DR. KIM THI NGUYEN OD
Optometrist
2195 SOUTHDALE CTR
EDINA, MN 55435
Hennepin County (952) 920-8607
TANVI MINESH PATEL OD
Optometrist
2195 SOUTHDALE CTR
EDINA, MN 55435
Hennepin County (952) 920-8607
DR. RODNEY ALBERT BINFET OD
Optometrist
2195 SOUTHDALE CTR
EDINA, MN 55435
Hennepin County (952) 920-8770
JOSEPH H. MARTIN OD, P.A.
Optometrist
2195 SOUTHDALE CTR
EDINA, MN 55435
Hennepin County (952) 920-8770

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 Randy Kelly's NPI number?

The NPI number for Randy Kelly is 1770537896. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Randy Kelly located?

Randy Kelly practices at 2195 Southdale Ctr, Edina, MN 55435. The listed phone number is (952) 920-8770.

What is Randy Kelly's specialty?

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

Is Randy Kelly enrolled in Medicare?

Yes. Randy Kelly 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 Randy Kelly accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Randy 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 Randy Kelly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.