DR. KELSEY MOORE (OD) – Optometrist, NPI 1154844017
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
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Provider Addresses for DR. KELSEY MOORE (OD)
13889, Ridgedale Drive, Minnetonka, Hennepin County, Minnesota, 55305, United States
MINNETONKA, MN 553051768
Phone: (763) 241-1090
Fax: (763) 241-1091
Type: Mailing
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN 554416200
Phone: (763) 545-8850
Fax: (763) 544-1257
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $472.
Total Amount is formed as General ($472) + Research ($0) + Ownership ($0) = $472.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Alcon Vision LLC ($303).
Total Amount
$472
General + Research + Ownership
Payments
11
Total payment records
General Amount
$472
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $303 |
| Johnson & Johnson Vision Care, Inc. | $114 |
| ABBVIE INC. | $23 |
| CooperVision Inc. | $16 |
| Oyster Point Pharma, Inc. | $15 |
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: 2020-04-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200427000837 | I | Optometry | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92250 | Photography of the retina | 21 | 21 | $0 |
| 92060 | Exam to measure eye deviation and range of motion | 20 | 11 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 15 | $0 |
| 92014 | Established patient complete exam of visual system | 14 | 13 | $0 |
| 92083 | Exam of visual field with extended testing | 11 | 11 | $0 |
Insurance plans in this area (ZIP 55305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN | |
| O P T O M E T R Y | MN |
Reviews
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