DR. SAMANTHA KELLY-SELTZER (O.D.) – Optometrist, NPI 1023070588

DR. SAMANTHA KELLY-SELTZER (O.D.) is a healthcare provider. based in Vienna, Virginia. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPT001892 (GA). The NPI Number for DR. SAMANTHA KELLY-SELTZER (O.D.) is 1023070588

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMANTHA KELLY-SELTZER (O.D.)
NPI
1023070588
Phone
(703) 847-8899
Address
1950 OLD GALLOWS RD STE 520
Enumeration Date
3 April 2006
Last Update Date
21 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9129260935
Graduation Year
1999 (27 years ago)
PAC ID
1153598008
Group Practice PAC ID
8224261201
Professional Enrollment ID
I20120118000508
Address ID
GA313269096RI594XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

958 OPTOMETRY in GA

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Provider Addresses for DR. SAMANTHA KELLY-SELTZER (O.D.)

  • 1950 OLD GALLOWS RD STE 520

    VIENNA, VA 221823970

    Phone: (703) 847-8899

    Fax: (866) 795-4020

    Type: Mailing

  • 4875, Altama Avenue, Suburban Estates, Brunswick, Glynn County, Georgia, 31520, United States

    BRUNSWICK, GA 315202912

    Phone: (912) 554-0010

    Fax: (912) 554-0075

    Type: Location

  • 7203 HODGSON MEMORIAL DR STE A

    SAVANNAH, GA 314061525

    Phone: (912) 352-9356

    Fax: (912) 352-9105

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $836.

Total Amount is formed as General ($836) + Research ($0) + Ownership ($0) = $836.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Alcon Vision LLC ($580).

Total Amount

$836

General + Research + Ownership

Payments

15

Total payment records

General Amount

$836

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

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: 2012-01-18

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
I20120118000508IOptometryGATBD

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 22182)

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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: 8224261201View full group profile

Reviews

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Frequently asked questions

What is the standard ID for DR. SAMANTHA KELLY-SELTZER (O.D.) in the U.S.?
In the U.S., DR. SAMANTHA KELLY-SELTZER (O.D.) is identified by NPI 1023070588.
Does the public listing show DR. SAMANTHA KELLY-SELTZER (O.D.) as active?
DR. SAMANTHA KELLY-SELTZER (O.D.)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. SAMANTHA KELLY-SELTZER (O.D.)'s specialty?
The extract shows Optometrist for DR. SAMANTHA KELLY-SELTZER (O.D.). Clinical services aligned with this taxonomy classification.
Is DR. SAMANTHA KELLY-SELTZER (O.D.) tied to Vienna, Virginia?
If you are local to Vienna, Virginia, DR. SAMANTHA KELLY-SELTZER (O.D.) may be relevant to your search.
Who maintains DR. SAMANTHA KELLY-SELTZER (O.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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