Kennedy Vision Health Center, LLC
NPI 1255165932ActiveOrganization· Optometrist· Otsego, MN
Optometrist in Otsego, Minnesota, registered in NPPES in August 2024. The authorized official on file is Anthony Charles Traverse, OD, Od/Owner. Enrolled in Medicare as dme supplier - physician - optometrist.
Overview
| NPI | 1255165932 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 27, 2024 |
| Last updated in NPPES | Aug 27, 2024 |
| Certified by provider | Aug 27, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (MN) |
|---|
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