Katherine Bautista Draviam, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS15083 Issued in FL

Practice address

391 N Main St
Kissimmee, FL 34744-5271

Phone

(407) 518-1074

NPI assigned

Apr 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: katherine.draviam.1@2183.direct.athenahealth.com

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.

• Florida Woman Care, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1386823243
  Medicare reassignment NPD
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1205246378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445271",
            "telephone_number": "407-518-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445271",
            "telephone_number": "407-518-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAVIAM",
        "first_name": "KATHERINE",
        "middle_name": "BAUTISTA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS15083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025080600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. S.J. Manikowski, O.D., P.a. & Associates
• Dr. Suraiya a.Kasu BDS PA
• Dragon Phoenix Acupuncture Inc
• Jeremy Marcus Drake, M.D.
• Shelley J Drake
• Sameer P Draviam, M.D.
• Jeremy A Drew, RN
• Mark Todd Dreyer, DMD
• DRG Medical Center, LLC
• Yohanna L Driggers

• Obstetrics & Gynecology Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.