DR. KELLY AR CLEVELAND – Optometrist, NPI 1164500963

DR. KELLY AR CLEVELAND is a healthcare provider. based in Dublin, Ohio. specializing in OPTOMETRY. They hold a License No. 5298 (OH). The NPI Number for DR. KELLY AR CLEVELAND is 1164500963

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY AR CLEVELAND
NPI
1164500963
Phone
(614) 789-5559
Address
6850 PERIMETER DR
Enumeration Date
1 November 2006
Last Update Date
28 February 2008

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
6147895559
Graduation Year
2002 (24 years ago)
PAC ID
0941200679
Group Practice PAC ID
4587664214
Professional Enrollment ID
I20070110000024
Address ID
OH430168051DU6850XDRXX302
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

1,618 OPTOMETRY in OH

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Provider Addresses for DR. KELLY AR CLEVELAND

  • 6850, Perimeter Drive, Dublin, Ohio, 43016, United States

    SUITE A

    DUBLIN, OH 430168051

    Phone: (614) 789-5559

    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: 2007-01-10

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
I20070110000024IOptometryOHTBD

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
92014Established patient complete exam of visual system3535$0
92134Imaging of retina1515$0
View full utilization report →

Insurance plans in this area (ZIP 43016)

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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: 4587664214View full group profile
NameSpecialtyState
O P T O M E T R YOH

Reviews

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Frequently asked questions

How do I look up DR. KELLY AR CLEVELAND by NPI?
Use NPI 1164500963 when you need to reference DR. KELLY AR CLEVELAND in forms, claims, or directories.
Is DR. KELLY AR CLEVELAND's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. KELLY AR CLEVELAND's specialty in plain language?
Clinically, the directory lists DR. KELLY AR CLEVELAND with Optometrist. Clinical services aligned with this taxonomy classification.
Where is DR. KELLY AR CLEVELAND's primary listing?
We display Dublin, Ohio because that is what the record indicates for DR. KELLY AR CLEVELAND.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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