KIMLY PHAM (O.D.) – Optometrist, NPI 1184216913

KIMLY PHAM (O.D.) is a healthcare provider. based in Strongsville, Ohio. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPT.006930 (OH). The NPI Number for KIMLY PHAM (O.D.) is 1184216913

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KIMLY PHAM (O.D.)
NPI
1184216913
Phone
(440) 783-5003
Address
17260 ROYALTON RD
Enumeration Date
3 February 2021
Last Update Date
28 September 2021

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
2163515300
Graduation Year
2020 (6 years ago)
PAC ID
9739625872
Group Practice PAC ID
3072426097
Professional Enrollment ID
I20240724003910
Address ID
OH441443327BR4762XRDXX300
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

1,618 OPTOMETRY in OH

Provider Addresses for KIMLY PHAM (O.D.)

  • 17260 ROYALTON RD

    STRONGSVILLE, OH 441364400

    Phone: (440) 783-5003

    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 3 Open Payments records for all available years, with a total value of $112.

Total Amount is formed as General ($112) + Research ($0) + Ownership ($0) = $112.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Alcon Vision LLC ($79).

Total Amount

$112

General + Research + Ownership

Payments

3

Total payment records

General Amount

$112

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

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: 2024-07-24

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
I20240724003910IOptometryOHTBD

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 44136)

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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: 3072426097View full group profile
NameSpecialtyState
O P T O M E T R YOH
O P T O M E T R YOH
O P T O M E T R YOH
O P T O M E T R YOH

Reviews

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Frequently asked questions

What identifier follows KIMLY PHAM (O.D.) across health systems?
The NPI 1184216913 uniquely identifies KIMLY PHAM (O.D.) in U.S. healthcare data.
Does the public listing show KIMLY PHAM (O.D.) as active?
KIMLY PHAM (O.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits KIMLY PHAM (O.D.)?
NPPES ties KIMLY PHAM (O.D.) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to KIMLY PHAM (O.D.)?
The directory associates KIMLY PHAM (O.D.) with Strongsville, Ohio. Check all listed addresses for suites or satellite offices.
Who maintains KIMLY PHAM (O.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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