Stephanie Dodd Minerella, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC005784 Issued in FL

Practice address

4337 S Florida Ave
Lakeland, FL 33813-1654

Phone

(863) 619-2700

Fax

(863) 648-9658

NPI assigned

Jun 16, 2020

Last updated

Jun 18, 2020By 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

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

New England College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Clearwater, FL
  • NPI 1730054594
  NPD
• Myeyedr. Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Lakeland, FL
  • NPI 1851762884
  NPD
• Myeyedr Optometry of Florida, LLC

  dba Myeyedr

  • Optometrist
  • Perry, FL
  • NPI 1437537529
  NPD (past)

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1528684453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4337 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131654",
            "telephone_number": "863-619-2700",
            "fax_number": "863-648-9658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5528 US Highway 98 N",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338093104",
            "country_code": "US",
            "telephone_number": "863-853-2020",
            "fax_number": "863-577-2008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1251 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054673",
            "country_code": "US",
            "telephone_number": "863-687-2260",
            "fax_number": "863-595-0927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINERELLA",
        "first_name": "STEPHANIE",
        "middle_name": "DODD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC005784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Roberto Miranda-Quesda, APRN

• Optometrist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.