Kennedy Vision Health Center, LLC
NPI 1033203963 · Optometrist · Plymouth, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kennedy Vision Health Center, LLC is a Optometrist organization in Plymouth, MN (NPI 1033203963).
Provider details
- NPI number
- 1033203963
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Anthony Traverse, Doctor(763) 545-8850
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Kenndy Vision Health Center
Additional practice locations (1)
- 9075 Quantrelle Ave Ne Ste 300Otsego, MN 55330-0139Phone: (763) 545-8850Fax: (763) 441-7631
Registry dates
- Enumerated
- 2006-10-03
- Last updated
- 2024-08-20
- Certified
- 2024-08-20
Frequently asked questions
- What is Kennedy Vision Health Center, LLC's NPI number?
- Kennedy Vision Health Center, LLC's National Provider Identifier (NPI) is 1033203963, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kennedy Vision Health Center, LLC?
- Kennedy Vision Health Center, LLC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Kennedy Vision Health Center, LLC located?
- Kennedy Vision Health Center, LLC's practice location on file with NPPES is 10600 Old County Road 15, Plymouth, MN 55441-6210.
- What is Kennedy Vision Health Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Kennedy Vision Health Center, LLC is (763) 545-8850.
- Does Kennedy Vision Health Center, LLC accept Medicare?
- Kennedy Vision Health Center, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kennedy Vision Health Center, LLC?
- The authorized official listed on Kennedy Vision Health Center, LLC's NPPES record is Anthony Traverse, Doctor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kennedy Vision Health Center, LLC's NPI active?
- Yes — Kennedy Vision Health Center, LLC's NPI (1033203963) is active in the NPPES registry as of the last update on 2024-08-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.