DR. SHELLEY S KIM (O.D.) – Optometrist, NPI 1396752846
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,715 OPTOMETRY in IL
Provider Addresses for DR. SHELLEY S KIM (O.D.)
1950 OLD GALLOWS RD STE 520
VIENNA, VA 221823970
Phone: (703) 847-8899
Fax: (571) 223-6780
Type: Mailing
865 ELMHURST RD
DES PLAINES, IL 600165605
Phone: (847) 437-1005
Fax: (847) 437-0755
Type: Location
1132, South Elmhurst Road, Mount Prospect, Elk Grove Township, Cook County, Illinois, 60056, United States
MT PROSPECT, IL 600564241
Phone: (847) 437-1005
Fax: (847) 437-0755
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $608.
Total Amount is formed as General ($608) + Research ($0) + Ownership ($0) = $608.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($225).
Total Amount
$608
General + Research + Ownership
Payments
18
Total payment records
General Amount
$608
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $225 |
| CooperVision Inc. | $185 |
| Tarsus Pharmaceuticals, Inc. | $145 |
| Alcon Vision LLC | $53 |
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: 2026-02-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050221000349 | I | Optometry | IL | TBD |
| I20260216002124 | I | Optometry | WI | TBD |
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.
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
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | WI | |
| - | WI | |
| O P T O M E T R Y | WI |
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