KENNETH D BOLTZ OD LLC
NPI 1992155204
Optometrist in Dublin, OH

Q: What is Kenneth D Boltz Od LLC's NPI number?

The NPI number for Kenneth D Boltz Od LLC is 1992155204. It was assigned to this organization in the NPPES registry on June 16, 2016.

Q: What is Kenneth D Boltz Od LLC's specialty?

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

Active since June 16, 2016

5775 PERIMETER DR, SUITE 160, DUBLIN, OH 43017(614) 763-5775(614) 675-3338 Get Directions Write a Review

NPPES record last updated: June 16, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kenneth D Boltz Od Llc NPPES

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

KENNETH D BOLTZ OD LLC (NPI 1992155204) is a healthcare organization registered as an optometrist in Dublin, Ohio and active in the NPI registry since June 2016. The organization lists Kenneth D Bolts, President, as its authorized official.

NPPES Registry Identity

NPI1992155204

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameKENNETH D BOLTZ OD LLC

Location Address5775 PERIMETER DR, SUITE 160Dublin, OH 43017-3238

Mailing Address5775 Perimeter Dr, Suite 160Dublin, OH 43017-3238 · (614) 763-5775 · Fax (614) 675-3338

Phone(614) 763-5775

Fax(614) 675-3338

Organization SubpartNo

Authorized OfficialKenneth D BoltsPresident · (614) 284-0794

Enumeration DateJune 16, 2016

✔ NPI 1992155204 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 OH · 3782

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.

5775 PERIMETER DR, Dublin, OH 43017

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth D Boltz Od Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kenneth D Boltz Od LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kenneth Boltz, O.D.

Optometry

NPI 1699767632

5775 PERIMETER DR STE 160
Dublin, OH 43017

(614) 763-5775

✔ PECOS✔ Accepts MedicareSame address

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

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 Kenneth D Boltz Od LLC's NPI number?

The NPI number for Kenneth D Boltz Od LLC is 1992155204. It was assigned to this organization in the NPPES registry on June 16, 2016.

Where is Kenneth D Boltz Od LLC located?

Kenneth D Boltz Od LLC is located at 5775 Perimeter Dr Suite 160, Dublin, OH 43017. The listed phone number is (614) 763-5775.

What is Kenneth D Boltz Od LLC's specialty?

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

Is Kenneth D Boltz Od LLC enrolled in Medicare?

Yes. Kenneth D Boltz Od LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kenneth D Boltz Od LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Kenneth D Boltz Od LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth D Boltz Od LLC was last updated on June 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.