KELLY F GROSDIDIER (OD) – Optometrist, NPI 1568466985

KELLY F GROSDIDIER (OD) is a healthcare provider. based in Overland park, Kansas. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 1427 (KS). The NPI Number for KELLY F GROSDIDIER (OD) is 1568466985

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
KELLY F GROSDIDIER (OD)
NPI
1568466985
Phone
(913) 491-3330
Address
8300 COLLEGE BLVD.
Enumeration Date
13 June 2005
Last Update Date
28 February 2019

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
9134913330
Graduation Year
1994 (32 years ago)
PAC ID
7416904800
Group Practice PAC ID
9830157635
Professional Enrollment ID
I20050407000550
Address ID
KS662102812OV8300XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

532 OPTOMETRY in KS

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Provider Addresses for KELLY F GROSDIDIER (OD)

  • 8300, College Boulevard, Overland Park, Johnson County, Kansas, 66210, United States

    SUITE 201

    OVERLAND PARK, KS 66210

    Phone: (913) 491-3330

    Fax: (913) 491-9650

    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)

CMS reports 4 Open Payments records for all available years, with a total value of $261.

Total Amount is formed as General ($261) + Research ($0) + Ownership ($0) = $261.

Last reported payment date: 2024-07-19 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($125).

Total Amount

$261

General + Research + Ownership

Payments

4

Total payment records

General Amount

$261

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-04-07

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
I20050407000550IOptometryKSTBD

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 66210)

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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: 9830157635View full group profile
NameSpecialtyState
O P H T H A L M O L O G YKS

Reviews

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Frequently asked questions

Does KELLY F GROSDIDIER (OD) have a public NPI I can cite?
Public records show KELLY F GROSDIDIER (OD) under NPI 1568466985.
Should I treat KELLY F GROSDIDIER (OD) as an active provider?
Patients and plans typically see KELLY F GROSDIDIER (OD) as active in the national extract.
What does the directory say KELLY F GROSDIDIER (OD) does?
Insurance directories may phrase it differently, but here KELLY F GROSDIDIER (OD) maps to Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to KELLY F GROSDIDIER (OD)?
The directory associates KELLY F GROSDIDIER (OD) with Overland Park, Kansas. Check all listed addresses for suites or satellite offices.
Who maintains KELLY F GROSDIDIER (OD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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