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DR. KEVIN DLYN WOODBURN O.D.
NPI 1912953217
Optometrist in Grass Valley, CA

Active since May 26, 2006PECOS EnrolledAccepts Medicare Assignment
97.54/100
CMS Quality Rating
400 SIERRA COLLEGE DR., SUITE A, GRASS VALLEY, CA 95945(530) 272-3411(530) 272-3474 Get Directions Write a Review

NPPES record last updated: January 10, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kevin Dlyn Woodburn O.d. NPPES

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

DR. KEVIN DLYN WOODBURN O.D. (NPI 1912953217) is an individual optometrist in Grass Valley, California, licensed in California (6840TLG) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1979).

NPPES Registry Identity

NPI1912953217
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. KEVIN DLYN WOODBURNCredential: O.D.
Location Address400 SIERRA COLLEGE DR., SUITE AGrass Valley, CA 95945
Mailing Address400 Sierra College Dr, Suite AGrass Valley, CA 95945-5093 · (530) 272-3411 · Fax (530) 272-3474
Phone(530) 272-3411
Fax(530) 272-3474
Sole ProprietorNo
Medical School CMSOtherGraduated 1979
Enumeration DateMay 26, 2006
Last NPPES UpdateJanuary 10, 2013
✔ NPI 1912953217 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 · 6840TLG
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.
400 SIERRA COLLEGE DR., Grass Valley, CA 95945
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Other Identifiers 3

MedicaidSD0068400CA
Medicare UPINT10424CA
Medicare PINZZZ86851ZCA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Dr. Kevin Dlyn Woodburn O.d. 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 ID2365407293
PECOS Enrollment IDI20041119000781
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 9

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.
507 services498 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
473 services257 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
156 services146 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
94 services88 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
41 services37 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.
35 services35 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95945 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

97.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost91.81

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 Kevin Woodburn's NPI number?

The NPI number for Kevin Woodburn is 1912953217. It was assigned to this individual provider in the NPPES registry on May 26, 2006.

Where is Kevin Woodburn located?

Kevin Woodburn practices at 400 Sierra College Dr. Suite A, Grass Valley, CA 95945. The listed phone number is (530) 272-3411.

What is Kevin Woodburn's specialty?

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

Is Kevin Woodburn enrolled in Medicare?

Yes. Kevin Woodburn 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 Kevin Woodburn accept?

Health plans from Providence Health Plan list Kevin Woodburn 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 Kevin Woodburn was last updated on January 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.