Organization Active NPI

Giannie Castellanos OD PA

  • Optometrist
  • Miami Lakes, FL
National Provider Identifier
1407267818
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4430 Issued in FL
Legal business name
GIANNIE CASTELLANOS OD PA
Practice address
8060 NW 155TH St
Ste 201
Miami Lakes, FL 33016-5883
Phone
(305) 364-3737
Fax
(305) 364-3737
NPI assigned
May 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Giannie Castellanos, ODNPI 1750514568
Title
OD/Owner
Phone
(305) 364-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC4430 FL Primary

Addresses

Primary practice location

8060 NW 155TH St
Ste 201
Miami Lakes, FL 33016-5883

Mailing address

8221 Dundee Ter
Miami Lakes, FL 33016-1410
Phone (305) 364-3737

Other practice location 1

7500 NW 25th St Ste 118
Miami, FL 33122-1721
Phone (305) 364-3737

Other identifiers 1

IdentifierTypeStateIssuer
1407267818MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170725003543 FL Part B Supplier - Clinic/Group Practice 2567732407 Receives reassigned benefits from 3 practitioners
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory
Tax ID family
Giannie Castellanos OD PA8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7500 NW 25th St
Ste 118
Miami, FL 33122

8060 NW 155th St
Ste 201
Miami Lakes, FL 33016
Phone (305) 826-0606

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1407267818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 DUNDEE TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161410",
            "telephone_number": "305-364-3737",
            "fax_number": "305-364-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 NW 155TH ST",
            "address_2": "STE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165883",
            "telephone_number": "305-364-3737",
            "fax_number": "305-364-3737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 NW 25th St Ste 118",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331221721",
            "country_code": "US",
            "telephone_number": "305-364-3737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GIANNIE CASTELLANOS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "CASTELLANOS",
        "authorized_official_first_name": "GIANNIE",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "305-364-3737",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407267818",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.