Deactivated NPI 1679639033 Deactivated / Inactive NPI Male Practitioner

Dr. Larry Brice Kelley , OD

Optometrist • Centralia, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Larry Kelley has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 29, 2006

NPI Deactivation Date April 12, 2021

Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Larry Kelley, OD was a registered Optometrist practicing in Centralia, WA. Throughout an active medical career spanning 15 years, Dr. Kelley provided care at the practice location at 1805 COOKS HILL RD until profile deactivation on 2021-04-12.

Historical Medicare Part B clinical services included established patient outpatient office visit, photography of the retina, exam of visual field with extended testing. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1805 Cooks Hill Rd

Centralia, WA 985319072

Telephone 3607364447

Fax 3608070324

Associated Practice Facility / Clinic

🏢 Halls Drug Center Inc Facility NPI 1396838512

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Centralia, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 32.7 Yrs

State Avg: 20.4 Yrs

Regional Practice Density

4 Specialists

Practicing in Centralia, WA (1692 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

12.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	17	17	$105.00	$92.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	176	91	$105.00	$75.96
92250 Photography of the retina	106	76	$111.00	$45.87
92083 Exam of visual field with extended testing	51	39	$115.00	$64.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	39	$149.00	$109.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	36	36	$150.00	$109.16
92020 Examination of cornea and iris using lens device and slit lamp	32	29	$41.00	$28.20
92014 Established patient complete exam of visual system	18	18	$166.00	$128.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	168	109	$149.46	$109.06
99213 Established patient office or other outpatient visit, typically 15 minutes	122	71	$105.00	$74.40
92250 Photography of the retina	122	94	$111.00	$51.14
92083 Exam of visual field with extended testing	55	39	$115.00	$64.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	39	39	$227.00	$164.64
92014 Established patient complete exam of visual system	36	36	$166.00	$127.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	267	118	$145.35	$102.08
92250 Photography of the retina	120	89	$111.00	$54.58
92225 Examination of eye by ophthalmoscope with retinal drawing	112	82	$52.00	$25.90
92083 Exam of visual field with extended testing	65	47	$115.00	$61.44
99213 Established patient office or other outpatient visit, typically 15 minutes	53	28	$105.00	$69.02
92014 Established patient complete exam of visual system	53	53	$166.00	$120.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$225.46	$156.01
92133 Imaging of optic nerve	15	13	$75.00	$35.47
92020 Examination of cornea and iris using lens device and slit lamp	12	12	$41.00	$25.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	307	144	$143.99	$100.12
92250 Photography of the retina	127	98	$111.00	$62.20
92225 Examination of eye by ophthalmoscope with retinal drawing	106	84	$51.98	$25.31
92083 Exam of visual field with extended testing	82	55	$115.00	$60.60
99213 Established patient office or other outpatient visit, typically 15 minutes	63	39	$105.00	$67.91
92014 Established patient complete exam of visual system	52	51	$166.00	$115.87
92020 Examination of cornea and iris using lens device and slit lamp	44	33	$41.00	$25.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	40	40	$225.00	$152.35
92133 Imaging of optic nerve	24	21	$75.00	$34.10

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License WA 1236

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Kelly Padgett , OD

Optometrist

NPI 1487933610

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated April 12, 2021

Record deactivated on April 12, 2021

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NPI Profile Active March 27, 2012

NPI status registered as active in NPPES database

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Updated Practice Location March 27, 2012

Registered at 1805 COOKS HILL RD, CENTRALIA, WA 985319072 (Tel: 3607364447)

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Updated Business Mailing Address March 27, 2012

Registered at PO BOX 1033, CENTRALIA, WA 985310716 (Tel: 3607364447)

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Provider Name / Credentials Updated March 27, 2012

Recorded as LARRY KELLEY, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2012

Optometrist (License #1236 in WA)

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Initial NPI Registration & Enumeration December 29, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679639033

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 29, 2006

Last Update: March 27, 2012

Deactivation Date: April 12, 2021

Update or Correct Profile

Mailing Address

Po Box 1033

Centralia, WA 985310716

Phone: 3607364447

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.