DR. STEPHEN MICHAEL KELLY (NPI# 1770652349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770652349 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN MICHAEL KELLY |
| Credential | O.D. |
| Practice Address |
851 Cherry Ave Bayhill Center #25 San Bruno CA 94066-2900 |
| Mailing Address |
2631 Sherwood Dr San Bruno CA 94066-1729 |
| Practice Telephone | 6508732020 |
| Practice Fax Number | 6508735251 |
| Mailing Telephone | 6508732020 |
| Mailing Fax Number | 6508735251 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT 6717 TPA | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SD0067170 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861023343 | Stephen M Kelly | Specialist/Technologist | N8021 Lake Breeze Dr, Sherwood, WI 54169-9613 | 2020-02-03 |
| 1235781584 | Stephen Kelly | Student in an Organized Health Care Education/Training Program | 2114 E Pinnacle Terrace Way Apt 302, Cottonwood Heights, UT 84121-5086 | 2019-07-16 |
| 1457601098 | Stephen Patrick Kelly | Mechanotherapist | 6080 Jericho Tpke Ste 200, Commack, NY 11725-2808 | 2012-09-11 |
| 1558504258 | Stephen Michael Kelly | Emergency Medicine | 333 Grand St, Ed - Jersey City Medical Center, Jersey City, NJ 07302-4319 | 2009-04-09 |
| 1245367663 | Stephen Michael Kelly | Internal Medicine | 1501 River Pointe Dr Ste 240, Conroe, TX 77304-2861 | 2007-02-27 |
| 1699722504 | Stephen Kelly | Physical Therapist | 80 Mill St, 1, Newton, NJ 07860-1411 | 2006-05-27 |
| 1689678518 | Stephen Kelly | Chiropractor | 403 S 3rd St, Youngwood, PA 15697-1154 | 2005-06-09 |
| 1457876310 | Stephen Michael Kelly | Registered Nurse | 1500 E Medical Center Dr, 1h247 University Hospital, Ann Arbor, MI 48109-5048 | 2017-08-11 |
| 1023321304 | Stephen Michael Kelly | Nurse Anesthetist, Certified Registered | 2021 Perdido St, New Orleans, LA 70112-1352 | 2010-07-15 |
| 1205059169 | Stephen J Kelly | Ophthalmology | 1830 14th Ave S, Birmingham, AL 35205-4969 | 2007-04-10 |
| Street Address |
851 CHERRY AVE BAYHILL CENTER #25 |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467096081 | Nergis Sevinc | Dentist | 851 Cherry Ave, San Bruno, CA 94066-2900 | 2019-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457533168 | Dr. Thomas Aller Optometrist, Inc. | Optometrist | 648 Jenevein Ave, San Bruno, CA 94066-4230 | 2007-12-04 |
| 1538246806 | Sherryl Lynne Quong | Optometrist | 476 San Mateo Ave, San Bruno, CA 94066-4437 | 2006-11-01 |
| 1700807369 | Connie Ha | Optometrist | 931 San Bruno Ave W Rm 4, San Bruno, CA 94066-3435 | 2006-07-21 |
| 1366431330 | Thomas A Aller | Optometrist | 711 Kains Ave, San Bruno, CA 94066-3404 | 2005-10-20 |
| 1982086401 | Jenny Chang Lam | Optometrist | 711 Kains Ave, San Bruno, CA 94066-3404 | 2015-06-20 |
| 1992114565 | Tracy Chan | Optometrist | 476 San Mateo Ave, San Bruno, CA 94066-4437 | 2014-08-08 |
| 1205198520 | Connie K Ha Od, Professional Corporation | Optometrist | 931 San Bruno Ave W Rm 4, San Bruno, CA 94066-3435 | 2012-06-12 |
| 1801175443 | Tammy Nguyen | Optometrist | 1122 El Camino Real, C/o Jcp Optical, San Bruno, CA 94066-2406 | 2011-08-14 |
| 1295030476 | Jennifer Chen | Optometrist | 476 San Mateo Ave, San Bruno, CA 94066-4437 | 2011-01-19 |
| 1619031549 | Elizabeth F Chen | Optometrist | 1178 El Camino Real, Space 265, San Bruno, CA 94066-2406 | 2006-12-22 |
| Find all providers in SAN BRUNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.