Individual provider Active NPI

Catherina Min, O.D.

  • Optometrist
  • Dacula, GA
National Provider Identifier
1124469275
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003375 Issued in GA
Practice address
2240 Hamilton Creek Pkwy Ste 1100
Dacula, GA 30019-4555
Phone
(678) 892-2020
Fax
(678) 538-1950
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60376275 WA
Optometrist 152W00000X OPT003375 GA Primary

Addresses

Primary practice location

2240 Hamilton Creek Pkwy Ste 1100
Dacula, GA 30019-4555

Mailing address

2240 Hamilton Creek Pkwy Ste 1100
Dacula, GA 30019-4555
Phone (678) 892-2020

Other practice location 1

2041 148th Ave NE
Bellevue, WA 98007-3725
Phone (425) 644-4226

Other practice location 2

17130 Avondale Way NE Ste 112
Redmond, WA 98052-4455
Phone (425) 885-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220128000823 GA Practitioner - Optometry 6608159470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Eye Group PCGroup PAC ID 2567455868, 51 clinicians

Practice addresses (Care Compare)

2240 Hamilton Creek Pkwy
Suite 1100
Dacula, GA 30019-4555
Phone (678) 892-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003375GAMDOptometrist
60376275WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Group PC Optometrist CurrentSince Feb 1, 2022 Accepting new patients
Thomas Eye Group PC Optometrist Current Accepting new patients
Thomas Eye Group PC CurrentSince Feb 1, 2022 Accepting new patients

Locations

546 Lakeland Plz
Cumming, GA 30040
Phone (678) 208-2393

2240 Hamilton Creek Pkwy
Ste 1100
Dacula, GA 30019
Phone (404) 582-0096

11690 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 475-5515

5901 Peachtree Dunwoody Rd
Ste 500
Sandy Springs, GA 30328
Phone (678) 781-7373

Interoperability endpoints

  • Direct secure messaging: catherinam@teg.emadirect.md

Organizations & group practices 3

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1124469275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 HAMILTON CREEK PKWY STE 1100",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194555",
            "telephone_number": "678-892-2020",
            "fax_number": "678-538-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 HAMILTON CREEK PKWY STE 1100",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194555",
            "telephone_number": "678-892-2020",
            "fax_number": "678-538-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 148th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073725",
            "country_code": "US",
            "telephone_number": "425-644-4226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17130 Avondale Way NE Ste 112",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980524455",
            "country_code": "US",
            "telephone_number": "425-885-6600",
            "fax_number": "425-885-6580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIN",
        "first_name": "CATHERINA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60376275",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.