KELLY D DELANGE (OD) – Optometrist, NPI 1285701029

KELLY D DELANGE (OD) is a healthcare provider. based in Fontana, California. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT10477T (CA). The NPI Number for KELLY D DELANGE (OD) is 1285701029

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
KELLY D DELANGE (OD)
NPI
1285701029
Phone
(909) 427-3910
Address
9961 SIERRA AVE
Enumeration Date
29 November 2006
Last Update Date
2 December 2021

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
9097245000
Graduation Year
1995 (31 years ago)
PAC ID
8921297607
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20110111000753
Address ID
CA917617925ON2295XAVEX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,909 OPTOMETRY in CA

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Provider Addresses for KELLY D DELANGE (OD)

  • Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States

    FONTANA, CA 923356720

    Phone: (909) 427-3910

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110111000753IOptometryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92335)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Can I cross-check KELLY D DELANGE (OD) using NPI 1285701029?
NPI 1285701029 belongs to KELLY D DELANGE (OD); compare other details if you need extra assurance.
Is KELLY D DELANGE (OD) still an active registrant?
KELLY D DELANGE (OD) carries an active NPI according to the public dataset.
What clinical focus is listed for KELLY D DELANGE (OD)?
At a glance, KELLY D DELANGE (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is KELLY D DELANGE (OD) located near Fontana?
KELLY D DELANGE (OD) currently maps to Fontana, California in this extract.
When was this NPI issued?
Enumeration for KELLY D DELANGE (OD) is noted as November 29, 2006 where the registry provides it.

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