KENDALL MATTONI (OD) – Optometrist, NPI 1538909056

KENDALL MATTONI (OD) is a healthcare provider. based in Rossford, Ohio. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT.007296 (OH). The NPI Number for KENDALL MATTONI (OD) is 1538909056

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KENDALL MATTONI (OD)
NPI
1538909056
Phone
(419) 666-0700
Address
647 Lime City Rd
Enumeration Date
31 May 2024
Last Update Date
31 May 2024

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
4196660700
Graduation Year
2024 (2 years ago)
PAC ID
0042755290
Group Practice PAC ID
7911909262
Professional Enrollment ID
I20240711002079
Address ID
OH434601444RO647XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,618 OPTOMETRY in OH

Provider Addresses for KENDALL MATTONI (OD)

  • 647 Lime City Rd

    Rossford, OH 434601444

    Phone: (419) 666-0700

    Type: Location

  • 1500 HUNTERS CHASE DR APT 3D

    WESTLAKE, OH 441456128

    Phone:

    Type: Mailing

  • 1261 W ROYALTON RD

    BROADVIEW HEIGHTS, OH 441472407

    Phone: (440) 526-7070

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $151.

Total Amount is formed as General ($151) + Research ($0) + Ownership ($0) = $151.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: CooperVision Inc. ($66).

Total Amount

$151

General + Research + Ownership

Payments

7

Total payment records

General Amount

$151

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: 2024-07-11

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
I20240711002079IOptometryOHTBD

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 43460)

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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: 7911909262View full group profile
NameSpecialtyState
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

Is KENDALL MATTONI (OD) listed with a National Provider Identifier?
Yes — KENDALL MATTONI (OD) has NPI 1538909056 on file in the registry.
Is there an active status for KENDALL MATTONI (OD)?
For scheduling context, KENDALL MATTONI (OD) is shown as active in the registry.
How would a patient describe KENDALL MATTONI (OD)'s focus?
For KENDALL MATTONI (OD), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with KENDALL MATTONI (OD)?
Directory geography for KENDALL MATTONI (OD) centers on Rossford, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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