Marina Yagudaev, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3753 Issued in FL

Practice address

17100 Collins Ave #112
Sunny Isles, FL 33160-3675

Phone

(305) 917-1037

Fax

(305) 917-1337

NPI assigned

May 10, 2006

Last updated

Mar 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sunny Isles Eye Center Inc

  • Optometrist
  • Sunny Isles Beach, FL
  • NPI 1851597611
  Medicare reassignment NPD Authorized official
• California Club Medical Center LLC

  • Family Medicine Physician
  • North Miami Beach, FL
  • NPI 1538106919
  NPD (past)
• Qualcare Medical Centers LLC

  dba California Club Medical Center

  • Family Medicine Physician
  • Miami, FL
  • NPI 1770872566
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1447209887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 COLLINS AVE #112",
            "city": "SUNNY ISLES",
            "state": "FL",
            "postal_code": "331603675",
            "telephone_number": "305-917-1037",
            "fax_number": "305-917-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 COLLINS AVE #112",
            "city": "SUNNY ISLES",
            "state": "FL",
            "postal_code": "331603675",
            "telephone_number": "305-917-1037",
            "fax_number": "305-917-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGUDAEV",
        "first_name": "MARINA",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIST LICENSE",
            "identifier": "OPC3753",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella Bunich
• Arilicia Williams, PCA

• Optometrist in Sunny Isles, FL
• Providers in Sunny Isles, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.