Individual provider Active NPI

Katheryn Elizabeth Cregan, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1083392070
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6290 Issued in FL
Practice address
1097 S Le Jeune Rd
Miami, FL 33134-2639
Phone
(305) 442-2020
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6290 FL Primary

Addresses

Primary practice location

1097 S Le Jeune Rd
Miami, FL 33134-2639

Mailing address

1500 NW North River Dr Apt 803
Miami, FL 33125-2687
Phone (518) 538-5039

Other identifiers 1

IdentifierTypeStateIssuer
119270400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119000667 FL Practitioner - Optometry 2567814171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J. Collins, Jr, MD, PAGroup PAC ID 1456320704, 10 clinicians

Practice addresses (Care Compare)

6900 International Ctr Blvd
Fort Myers, FL 33912-7151
Phone (239) 936-4706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6290FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aran Eye Associates PA CurrentSince Nov 11, 2023 Accepting new patients
Michael J. Collins, Jr, MD, PA CurrentSince Feb 1, 2025 Accepting new patients
Aran Eye Associates PA CurrentSince May 26, 2024 Accepting new patients
Aran Eye Associates PA CurrentSince Nov 11, 2023 Accepting new patients
Stanley D Braverman MD LLC Optometrist PastSince Nov 11, 2023 Accepting new patients

Locations

6900 International Center Blvd
Fort Myers, FL 33912
Phone (239) 593-7747

7600 NW 19th St
Ste 200
Miami, FL 33126

7600 Corporate Center Dr
Miami, FL 33126

1097 S Le Jeune Rd
Miami, FL 33134
Phone (305) 442-2021

875 105th Ave N
Naples, FL 34108
Phone (239) 262-4798

290 NW 165th St
Ph 2
North Miami Beach, FL 33169
Phone (305) 949-1600

290 NW 165th St
Ste L100
North Miami Beach, FL 33169
Phone (305) 494-1600

3665 Tamiami Trl
Unit 101
Punta Gorda, FL 33950
Phone (239) 936-4706

14201 W Sunrise Blvd
#101101
Sunrise, FL 33323
Phone (954) 838-1382

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1083392070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NW NORTH RIVER DR APT 803",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252687",
            "telephone_number": "518-538-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 S LE JEUNE RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331342639",
            "telephone_number": "305-442-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREGAN",
        "first_name": "KATHERYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119270400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.