DR. EASTON CLINT KELSEY (O.D.) – Optometrist, NPI 1063470466
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. EASTON CLINT KELSEY (O.D.)
3651 WALL AVE STE 1226
OGDEN, UT 844052007
Phone: (480) 732-9040
Type: Location
4907 S 1750 W
5
ROY, UT 84067
Phone: (480) 204-9122
Type: Mailing
South Alma School Road, Chandler, Maricopa County, Arizona, 85244, United States
STE 28
CHANDLER, AZ 852488118
Phone: (480) 732-9040
Fax: (480) 782-9579
Type: Location
1325, South Minneola Lane, Agritopia, Gilbert, Maricopa County, Arizona, 85296, United States
GILBERT, AZ 85296
Phone: (336) 908-2024
Fax: (480) 782-9579
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $875.
Total Amount is formed as General ($875) + Research ($0) + Ownership ($0) = $875.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($485).
Total Amount
$875
General + Research + Ownership
Payments
19
Total payment records
General Amount
$875
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $485 |
| Johnson & Johnson Vision Care, Inc. | $184 |
| ABBVIE INC. | $77 |
| Glaukos Corporation | $70 |
| Alcon Vision LLC | $32 |
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: 2019-06-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190624001064 | I | Optometry | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92004 | New patient complete exam of visual system | 13 | 13 | $0 |
| 92014 | Established patient complete exam of visual system | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84405)
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