KIMBERLEY W. CHAN (O.D.) – Pediatric Optometrist, NPI 1104908458

KIMBERLEY W. CHAN (O.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in Pediatric Optometrist. They hold the professional credentials O.D.. They hold a License No. 4522 (MA). The NPI Number for KIMBERLEY W. CHAN (O.D.) is 1104908458

Main info

Female
Name
KIMBERLEY W. CHAN (O.D.)
NPI
1104908458
Phone
(617) 573-4169
Address
243 CHARLES ST
Enumeration Date
19 October 2006
Last Update Date
8 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KIMBERLEY W. CHAN (O.D.)

  • Massachusetts Eye and Ear, 243, Charles Street, Beacon Hill, Boston, Suffolk County, Massachusetts, 02114, United States

    BOSTON, MA 021143002

    Phone: (617) 573-4169

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-10-04

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
I20051004000535IOptometryMATBD

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 02114)

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Reviews

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Frequently asked questions

Can I verify KIMBERLEY W. CHAN (O.D.) with an NPI only?
You can start verification with NPI 1104908458 for KIMBERLEY W. CHAN (O.D.), then check state licensing separately.
Does the file indicate KIMBERLEY W. CHAN (O.D.) is practicing under active NPI?
Directory data currently reports KIMBERLEY W. CHAN (O.D.) as active.
What is KIMBERLEY W. CHAN (O.D.)'s primary classification?
Pediatric Optometrist is the headline specialty for KIMBERLEY W. CHAN (O.D.) here. Clinical services aligned with this taxonomy classification.
Does KIMBERLEY W. CHAN (O.D.) list a practice location?
Patients near Boston, Massachusetts may find KIMBERLEY W. CHAN (O.D.) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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