DR. KIMBER MARIE KENZLI (OD) – Optometrist, NPI 1003477902

DR. KIMBER MARIE KENZLI (OD) is a healthcare provider. based in University place, Washington. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OD60943168 (WA). The NPI Number for DR. KIMBER MARIE KENZLI (OD) is 1003477902

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIMBER MARIE KENZLI (OD)
NPI
1003477902
Phone
(253) 579-6962
Address
4712 97TH AVE W APT C
Enumeration Date
22 June 2019
Last Update Date
26 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3606989500
Graduation Year
2019 (7 years ago)
PAC ID
7113348970
Group Practice PAC ID
1254229248
Professional Enrollment ID
I20200603001811
Address ID
WA983836000SI3260XWAYX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

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Provider Addresses for DR. KIMBER MARIE KENZLI (OD)

  • 4712 97TH AVE W APT C

    UNIVERSITY PLACE, WA 984661364

    Phone: (253) 579-6962

    Type: Mailing

  • Northwest Vision Development Center, 1705, South 324th Place, Federal Way Plaza South, Federal Way, King County, Washington, 98003, United States

    FEDERAL WAY, WA 980038504

    Phone: (253) 661-6005

    Type: Location

  • PO BOX 5299

    MS: 820-5-PCO

    TACOMA, WA 984150299

    Phone:

    Type: Mailing

  • 9800 LEVIN RD NW STE 208

    SILVERDALE, WA 983837849

    Phone: (360) 698-0600

    Fax: (360) 613-0222

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2024-06-24 • Largest payer in this snapshot: CooperVision Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CooperVision Inc.$14
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: 2020-06-03

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
I20200603001811IOptometryWATBD

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 system3131$0
99213Established patient office or other outpatient visit, 20-29 minutes1714$0
92004New patient complete exam of visual system1616$0
View full utilization report →

Insurance plans in this area (ZIP 98466)

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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: 1254229248View full group profile
NameSpecialtyState
O P H T H A L M O L O G YWA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YWA
O P H T H A L M O L O G YIN
O P H T H A L M O L O G YWA
O P H T H A L M O L O G YWA
-MN

Reviews

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Frequently asked questions

How do payers reference DR. KIMBER MARIE KENZLI (OD)?
For DR. KIMBER MARIE KENZLI (OD), use NPI 1003477902 as the unique 10-digit identifier.
Active or inactive — what applies to DR. KIMBER MARIE KENZLI (OD)?
You should see DR. KIMBER MARIE KENZLI (OD) as active in CMS-hosted NPPES data.
What kind of doctor is DR. KIMBER MARIE KENZLI (OD)?
DR. KIMBER MARIE KENZLI (OD) is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
Is DR. KIMBER MARIE KENZLI (OD) located near University Place?
DR. KIMBER MARIE KENZLI (OD) currently maps to University Place, Washington in this extract.
Can I trust this NPI listing for DR. KIMBER MARIE KENZLI (OD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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