Katherine M Severin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP8122T Issued in CA

Practice address

3700 Hilborn Rd Ste 500
Fairfield, CA 94534-7997

Phone

(707) 426-2020

NPI assigned

Sep 30, 2005

Last updated

Oct 26, 2010By 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Family Eye Associates

  • Corneal and Contact Management Optometrist
  • Fairfield, CA
  • NPI 1871619973
  Authorized official Same address or phone
• Family Eye Associates Optometric Group, Inc.

  • Optometrist
  • Fairfield, CA
  • NPI 1528627932
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1598752909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 HILBORN RD STE 500",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347997",
            "telephone_number": "707-426-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 HILBORN RD STE 500",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347997",
            "telephone_number": "707-426-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERIN",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OP8122T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "680346182",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "SD0081220",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5666727",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seturam Pandurangi MD a Profession Corporation
• Faanuu Seumanutusa
• Seven Oaks Home Health
• Seven Oaks Home Health LLC
• Anca Severin, LMFT
• Bonnie Sgroi, APRN, AGCNS-BC
• Jowhar Shabazz
• Mojdeh Shafaghi
• Christopher Shafer
• Kathleen M. Shafer, M.A., R.D.

• Optometrist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.