Kennedy Vision Health Center, LLC
NPI 1033203963ActiveOrganization· Optometrist· Plymouth, MN
Optometrist in Plymouth, Minnesota, registered in NPPES in October 2006. The authorized official on file is Anthony Charles Traverse, O.D., Doctor. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1033203963 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 3, 2006 |
| Last updated in NPPES | Aug 20, 2024 |
| Certified by provider | Aug 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (MN); Part B Supplier - Clinic/Group Practice (MN) |
|---|
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