KELSEY WILSON (OD) – Optometrist, NPI 1083291454

KELSEY WILSON (OD) is a healthcare provider. based in Sanford, Maine. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT1044 (ME). The NPI Number for KELSEY WILSON (OD) is 1083291454

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY WILSON (OD)
NPI
1083291454
Phone
(207) 324-8888
Address
272 COTTAGE ST
Enumeration Date
24 March 2021
Last Update Date
17 November 2021

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
2073248888
Graduation Year
2021 (5 years ago)
PAC ID
5294137030
Group Practice PAC ID
7012951775
Professional Enrollment ID
I20210715002290
Address ID
ME040731815SA272XXSTXX300

Contacts

Secure Messaging
kelsey.wilson2@direct.revolutionehr.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

219 OPTOMETRY in ME

Provider Addresses for KELSEY WILSON (OD)

  • 272 COTTAGE ST

    SANFORD, ME 040731815

    Phone: (207) 324-8888

    Fax: (207) 636-5023

    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 16 Open Payments records for all available years, with a total value of $310.

Total Amount is formed as General ($310) + Research ($0) + Ownership ($0) = $310.

Last reported payment date: 2024-12-14 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($72).

Total Amount

$310

General + Research + Ownership

Payments

16

Total payment records

General Amount

$310

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-14

Latest reported date

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: 2021-07-15

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
I20210715002290IOptometryMETBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens1,26715$0
92250Photography of the retina174171$0
92014Established patient complete exam of visual system169169$0
99213Established patient office or other outpatient visit, 20-29 minutes125106$0
92004New patient complete exam of visual system7777$0
View full utilization report →

Insurance plans in this area (ZIP 04073)

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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: 7012951775View full group profile
NameSpecialtyState
O P T O M E T R YME
O P T O M E T R YME
O P T O M E T R YME
O P T O M E T R YME
O P T O M E T R YME
O P T O M E T R YME
O P T O M E T R YME
-ME
O P T O M E T R YME
O P T O M E T R YME

Reviews

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Frequently asked questions

How is KELSEY WILSON (OD) identified in CMS data?
CMS-hosted NPPES data lists KELSEY WILSON (OD) with NPI 1083291454.
Does CMS list KELSEY WILSON (OD) as active?
Yes — KELSEY WILSON (OD) is active in the NPI listing used on this page.
What is KELSEY WILSON (OD)'s specialty?
The listing groups KELSEY WILSON (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What area does KELSEY WILSON (OD) serve?
KELSEY WILSON (OD)'s listing highlights Sanford, Maine; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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