DR. IAIN M SR. KELLY (OD) – Optometrist, NPI 1366475014

DR. IAIN M SR. KELLY (OD) is a healthcare provider. based in Kettering, Ohio. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 4207 (OH). The NPI Number for DR. IAIN M SR. KELLY (OD) is 1366475014

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. IAIN M SR. KELLY (OD)
NPI
1366475014
Phone
(937) 297-7676
Address
3100 GOVERNORS PLACE BLVD
Enumeration Date
8 July 2006
Last Update Date
21 September 2021

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9372977676
Graduation Year
1990 (36 years ago)
PAC ID
0143290577
Group Practice PAC ID
9335161231
Professional Enrollment ID
I20040730001082
Address ID
OH454091334KE3100XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,618 OPTOMETRY in OH

Provider Addresses for DR. IAIN M SR. KELLY (OD)

  • 3100 GOVERNORS PLACE BLVD

    KETTERING, OH 454091334

    Phone: (937) 297-7676

    Type: Location

  • PO BOX 33

    MEDWAY, OH 453410033

    Phone: (937) 776-4788

    Type: Mailing

  • 1370, North Fairfield Road, Zimmerman, Beavercreek, Greene County, Ohio, 45432, United States

    SUITE A

    BEAVERCREEK, OH 454322675

    Phone: (937) 426-2212

    Fax: (937) 426-3975

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 33 Open Payments records for all available years, with a total value of $1,142.

Total Amount is formed as General ($1,142) + Research ($0) + Ownership ($0) = $1,142.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($603).

Total Amount

$1,142

General + Research + Ownership

Payments

33

Total payment records

General Amount

$1,142

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

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: 2004-07-30

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
I20040730001082IOptometryOHTBD

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 system235231$0
92004New patient complete exam of visual system4747$0
99213Established patient office or other outpatient visit, 20-29 minutes2624$0
92134Imaging of retina1614$0
View full utilization report →

Insurance plans in this area (ZIP 45409)

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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: 9335161231View full group profile
NameSpecialtyState
-OH
O P H T H A L M O L O G YOH
Ophthalmology, Plastic And Reconstructive SurgeryOH

Reviews

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Frequently asked questions

What is DR. IAIN M SR. KELLY (OD)'s NPI number?
DR. IAIN M SR. KELLY (OD)'s NPI is 1366475014 — the number used across U.S. healthcare to identify this provider.
Would DR. IAIN M SR. KELLY (OD) appear as active to a payer?
You can treat DR. IAIN M SR. KELLY (OD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. IAIN M SR. KELLY (OD)?
DR. IAIN M SR. KELLY (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. IAIN M SR. KELLY (OD)?
Travel planning: use Kettering, Ohio as the reference point for DR. IAIN M SR. KELLY (OD), then confirm.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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