KELLEN EARL PLOMSKI OD, MPH
NPI 1902461361
Optometrist in Clackamas, OR
About Kellen Earl Plomski Od, Mph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEN EARL PLOMSKI OD, MPH (NPI 1902461361) is an individual optometrist in Clackamas, Oregon, licensed in Oregon (4447ATI) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
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
Kellen Earl Plomski Od, Mph 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
4Medicare enrollment records show Kellen Plomski reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clackamas, OR 97015
- Reassigned Medicare billing, Oregon and Washington enrollments
- Also billed through NPI 1871848457 (Washington)
- 3,207 clinicians in this Medicare group
West Linn, OR 97068
- Reassigned Medicare billing, Oregon enrollment
- 8 clinicians in this Medicare group
Tigard, OR 97223
- Reassigned Medicare billing, Oregon enrollment
- 10 clinicians in this Medicare group
Beaverton, OR 97007
- Reassigned Medicare billing, Oregon enrollment
- 9 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97086 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 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CLACKAMAS, OR 97086
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 Kellen Plomski's NPI number?
The NPI number for Kellen Plomski is 1902461361. It was assigned to this individual provider in the NPPES registry on May 1, 2019.
Where is Kellen Plomski located?
Kellen Plomski practices at 12100 SE Stevens Ct Ste 106, Clackamas, OR 97086. The listed phone number is (800) 813-2000.
What is Kellen Plomski's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Kellen Plomski enrolled in Medicare?
Yes. Kellen Plomski 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 Kellen Plomski's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kellen Plomski reassigns Medicare benefits to 4 organizations: Kaiser Foundation Health Plan Of The Northwest (Clackamas, OR), West Linn Vision Center Inc (West Linn, OR), Tigard Vision Center, Inc. (Tigard, OR) and Murray Scholls Optique Inc (Beaverton, OR). 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 Kellen Plomski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kellen Plomski accept?
Health plans from Kaiser Permanente and PacificSource Health Plans list Kellen Plomski 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 Kellen Plomski was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Kellen Earl Plomski, OD, MPH · NPI 1902461361
Optometrist provider in Clackamas, Oregon. Individual provider, active in the CMS NPPES registry since May 1, 2019.
## Identity
- **NPI:** 1902461361 (Entity type: Individual)
- **Enumerated:** May 1, 2019
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 4447ATI (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 12100 SE STEVENS CT STE 106, Clackamas, OR 97086-4707
- **Phone:** (800) 813-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Kaiser Foundation Health Plan Of The Northwest (NPI 1174851505, Clackamas, OR); West Linn Vision Center Inc (NPI 1043769227, West Linn, OR); Tigard Vision Center, Inc. (NPI 1821083635, Tigard, OR); Murray Scholls Optique Inc (NPI 1598751802, Beaverton, OR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** January 14, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1902461361) · Data from the CMS NPPES public registry.