Individual provider Active NPI

Katie M Salomon, OD

  • Optometrist
  • Winter Haven, FL
National Provider Identifier
1154739852
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4961 Issued in FL
Practice address
570 Avenue K SE
Winter Haven, FL 33880-4203
Phone
(863) 401-4200
Fax
(863) 220-9912
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4961 FL Primary

Addresses

Primary practice location

570 Avenue K SE
Winter Haven, FL 33880-4203

Mailing address

570 Avenue K SE
Winter Haven, FL 33880-4203
Phone (863) 401-4200

Other identifiers 1

IdentifierTypeStateIssuer
105924700MedicaidFL

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
I20140917002030 FL Practitioner - Optometry 4385863794 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salomon Eye Care PAGroup PAC ID 9234545393, 3 clinicians

Practice addresses (Care Compare)

570 Ave K SE
Winter Haven, FL 33880-4203
Phone (863) 401-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salomon Eye Care PA Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jan 11, 2021 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jan 1, 2016 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jan 11, 2021 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Jan 1, 2016 Accepting new patients

Locations

1695 N Broadway Ave
Bartow, FL 33830
Phone (863) 534-2020

3140 Citrus Tower Blvd
#11
Clermont, FL 34711
Phone (352) 243-2121

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

119 Patterson Rd
Haines City, FL 33844
Phone (863) 419-1300

1251 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-2260

4337 S Florida Ave
Lakeland, FL 33813
Phone (863) 619-2700

5528 US Highway 98 N
Lakeland, FL 33809
Phone (863) 294-5457

102 Henry Ave
Plant City, FL 33563
Phone (813) 704-6090

1040 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 654-5453

3600 US 27 N
Sebring, FL 33870
Phone (863) 294-5457

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

570 Avenue K SE
Winter Haven, FL 33880
Phone (863) 299-6476

215 1st St N
Ste 100
Winter Haven, FL 33881
Phone (863) 299-8908

215 1st St N
Winter Haven, FL 33881
Phone (863) 299-8908

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1154739852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804203",
            "telephone_number": "863-401-4200",
            "fax_number": "863-220-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804203",
            "telephone_number": "863-401-4200",
            "fax_number": "863-220-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "KATIE",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105924700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.