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KELLY PHAM OD
NPI 1891368593
Optometrist in Westminster, CA

Active since July 20, 2021PECOS Enrolled
9741 BOLSA AVE STE 115, WESTMINSTER, CA 92683(714) 839-9915(714) 839-9974 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 27, 2025, Apr 1, 2025, Mar 27, 2025 and 2 more (5 updates tracked since 2021).

About Kelly Pham Od NPPES

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

KELLY PHAM OD (NPI 1891368593) is an individual optometrist in Westminster, California, licensed in California (34887) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Irvine.

NPPES Registry Identity

NPI1891368593
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKELLY PHAMCredential: OD
Location Address9741 BOLSA AVE STE 115Westminster, CA 92683-6683
Mailing Address13742 Wilson StWestminster, CA 92683-3336 · (714) 757-7605 · Fax (714) 839-9974
Phone(714) 839-9915
Fax(714) 839-9974
Sole ProprietorNo
Enumeration DateJuly 20, 2021
Last NPPES UpdateJune 27, 20255 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
✔ NPI 1891368593 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 · 34887
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.
9741 BOLSA AVE STE 115, Westminster, CA 92683
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Secondary Practice Location 1

Location 1900 Spectrum Center DrIrvine, CA 92618-4958 · Phone (949) 885-0225

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Pham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tedder Optometric Corporation, PC
17 mi
Optometrist
23625 EL TORO RD STE E
Lake Forest, CA 92630
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Hansra Optometric Corporation
  • 34 clinicians in this Medicare group
NPI 1679262158 (949) 227-2524

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92683 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.

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 Kelly Pham's NPI number?

The NPI number for Kelly Pham is 1891368593. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Where is Kelly Pham located?

Kelly Pham practices at 9741 Bolsa Ave Ste 115, Westminster, CA 92683. The listed phone number is (714) 839-9915.

What is Kelly Pham's specialty?

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

Is Kelly Pham enrolled in Medicare?

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

Which organization bills Medicare for Kelly Pham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Pham reassigns Medicare benefits to Tedder Optometric Corporation, PC (Lake Forest, CA). The 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 Kelly Pham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Pham accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Kelly Pham 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 Kelly Pham was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.