DR. JOAN KEDDINGTON (O.D.) – Optometrist, NPI 1992872691

DR. JOAN KEDDINGTON (O.D.) is a healthcare provider. based in Bonita, California. specializing in Optometrist. They hold the professional credentials O.D.. They hold a License No. 6263T (CA). The NPI Number for DR. JOAN KEDDINGTON (O.D.) is 1992872691

Main info

Female
49 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOAN KEDDINGTON (O.D.)
NPI
1992872691
Phone
(619) 421-8929
Address
1773 COUNTRY VISTAS LN
Enumeration Date
29 November 2006
Last Update Date
23 March 2009

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
6194772159
Graduation Year
1977 (49 years ago)
PAC ID
0648217158
Group Practice PAC ID
0749290567
Professional Enrollment ID
I20060425000132
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. JOAN KEDDINGTON (O.D.)

  • 1773 COUNTRY VISTAS LN

    BONITA, CA 919023076

    Phone: (619) 421-8929

    Fax: (619) 271-6315

    Type: Mailing

  • 1481, East Plaza Boulevard, National City, San Diego County, California, 91950, United States

    NATIONAL CITY, CA 919503613

    Phone: (619) 477-2159

    Fax: (619) 477-2128

    Type: Location

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: 2006-04-25

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
I20060425000132IOptometryCATBD

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 91902)

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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: 0749290567View full group profile
NameSpecialtyState
-CA

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Frequently asked questions

Does DR. JOAN KEDDINGTON (O.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. JOAN KEDDINGTON (O.D.) uses 1992872691.
Is DR. JOAN KEDDINGTON (O.D.) listed as active for patients and plans?
The listing shows DR. JOAN KEDDINGTON (O.D.) as active in the NPI system.
What is DR. JOAN KEDDINGTON (O.D.)'s primary classification?
Optometrist is the headline specialty for DR. JOAN KEDDINGTON (O.D.) here. Clinical services aligned with this taxonomy classification.
Does DR. JOAN KEDDINGTON (O.D.) list a practice location?
Patients near Bonita, California may find DR. JOAN KEDDINGTON (O.D.) in results; validate coverage separately.
Why does DR. JOAN KEDDINGTON (O.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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