Katherine Orellana Medina, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3853 Issued in FL

Practice address

9773 W Sample Rd
Coral Springs, FL 33065-4003

Phone

(954) 753-0137

Fax

(954) 753-0139

NPI assigned

Apr 21, 2006

Last updated

Oct 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Katherine L. Orellana-Medina

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1124321567
  NPD Authorized official
• Coral Springs Vision Care PLLC

  dba VISION SOURCE Coral Springs

  • Optometrist
  • Coral Springs, FL
  • NPI 1346564325
  Authorized official Same address or phone
• Dawn T Van O D P a

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1568649275
  NPD (past)
• Optical on Main Inc

  • Optician
  • New Rochelle, NY
  • NPI 1528095593
  NPD (past)

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1356307193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9773 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654003",
            "telephone_number": "954-753-0137",
            "fax_number": "954-753-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9773 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654003",
            "telephone_number": "954-753-0137",
            "fax_number": "954-753-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORELLANA MEDINA",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006221",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000557300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02072966",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2390358",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "TUV006221",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6501441",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimum Diagnostics Inc
• Optimum Health and Wound Care LLC
• Optimum Health Wellness and Rehab
• Optumcare South Florida, LLC (Healthcare Partners South Florida LLC)
• Elizabeth Ann Ordonez, LCSW
• Orin M. Levy, M.D., P.a.
• Ortho Florida, LLC (Sports Ortho, LLC)
• Ortho-Pedo Associates, PA
• Orthoandmore Inc
• Omar Ortiz-Alvarado, M.D.

• Optometrist in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.