Bert Edmond Ketchum III, OD
NPI 1174107866ActiveIndividual· Optometrist· Fpo, AP
Optometrist (OD) in Fpo, Armed Forces Pacific, licensed in VA, with an NPI issued in May 2021. Enrolled in Medicare as order and referring only - optometry.
Overview
| NPI | 1174107866 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OD |
| Sole proprietor | No |
| NPI issued | May 8, 2021 |
| Last updated in NPPES | Aug 25, 2026 |
| Certified by provider | Aug 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 0618003037 | VA |
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 Order and Referring Only - Optometry (VA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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