Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kelsey Moore, OD

Individual provider Pediatric Optometrist · NPI 1154844017

Dr. Kelsey Moore, OD is an Optometry in Plymouth, Minnesota. Qualified in 2017, 9 years ago. Practices with Kennedy Vision Health Center LLC, a 7-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2017
Specialties on file
3
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

See every abbreviation used in this directory →

Practice location Address checks out

10600 Old County Road 15
Plymouth, MN 55441-6200
Phone: (763) 545-8850
Fax: (763) 544-1257
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3563 (MN)
Pediatric Optometrist Taxonomy 152WP0200X · Licence 3563 (MN)
Vision Therapy Optometrist Taxonomy 152WV0400X · Licence 3563 (MN)

Record details

NPI number1154844017
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 24, 2017
Last updated in NPPESFebruary 5, 2023
Certification dateFebruary 5, 2023
Mailing address10600 Old County Road 15, Plymouth, MN 55441-6200

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Kennedy Vision Health Center Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount