DR. ELLEN KAY BRALEY (OD) – Optometrist, NPI 1619595352

DR. ELLEN KAY BRALEY (OD) is a healthcare provider. based in Carlinville, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046.011451 (IL). The NPI Number for DR. ELLEN KAY BRALEY (OD) is 1619595352

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. ELLEN KAY BRALEY (OD)
NPI
1619595352
Phone
(217) 854-7611
Address
300 N BROAD ST
Enumeration Date
9 July 2020
Last Update Date
9 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7735883090
Graduation Year
2020 (6 years ago)
PAC ID
4880014992
Group Practice PAC ID
7012175102
Professional Enrollment ID
I20201012000826
Address ID
IL606593307CH3500XAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for DR. ELLEN KAY BRALEY (OD)

  • 300 N BROAD ST

    CARLINVILLE, IL 626261304

    Phone: (217) 854-7611

    Fax: (217) 854-8120

    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: 2020-10-12

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
I20201012000826IOptometryILTBD

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 62626)

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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: 7012175102View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YNJ
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YNE
O P T O M E T R YIL
O P T O M E T R YWI
O P T O M E T R YWI
O P T O M E T R YIL

Reviews

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Frequently asked questions

How do payers reference DR. ELLEN KAY BRALEY (OD)?
For DR. ELLEN KAY BRALEY (OD), use NPI 1619595352 as the unique 10-digit identifier.
Active or inactive — what applies to DR. ELLEN KAY BRALEY (OD)?
You should see DR. ELLEN KAY BRALEY (OD) as active in CMS-hosted NPPES data.
How would a patient describe DR. ELLEN KAY BRALEY (OD)'s focus?
For DR. ELLEN KAY BRALEY (OD), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. ELLEN KAY BRALEY (OD) located near Carlinville?
DR. ELLEN KAY BRALEY (OD) currently maps to Carlinville, Illinois in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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