Individual provider Active NPI

Keri Marie Pomella, OD

  • Optometrist
  • Hialeah, FL
National Provider Identifier
1316978364
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3040 Issued in FL
Practice address
1550 W 84TH St Ste 14
Hialeah, FL 33014-3368
Phone
(305) 556-6946
Fax
(305) 602-8153
NPI assigned
Jul 6, 2006
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3040 FL Primary

Addresses

Primary practice location

1550 W 84TH St Ste 14
Hialeah, FL 33014-3368

Mailing address

1550 W 84TH St Ste 15
Hialeah, FL 33014-3368
Phone (305) 556-6946

Other identifiers 1

IdentifierTypeStateIssuer
620495300MedicaidFL

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
I20050615000021 FL Practitioner - Optometry 5193769958 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keri M Pomella, OD PA Optometrist CurrentSince Mar 1, 2020 Accepting new patients
Keri M Pomella, OD PA Optometrist Past Accepting new patients
Keri M Pomella, OD PA Optometrist Past Accepting new patients
Keri M Pomella OD PA Optometrist Past Accepting new patients

Locations

1550 W 84th St
Ste 14
Hialeah, FL 33014
Phone (305) 556-6946

1550 W 84th St
Ste 15
Hialeah, FL 33014
Phone (305) 824-1448

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1316978364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 W 84TH ST STE 15",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143368",
            "telephone_number": "305-556-6946",
            "fax_number": "305-602-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W 84TH ST STE 14",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143368",
            "telephone_number": "305-556-6946",
            "fax_number": "305-602-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMELLA",
        "first_name": "KERI",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620495300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.