Kaitlyn Cezanne Rothberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4840 Issued in FL

Practice address

2201 4TH St N
Ste a
St Petersburg, FL 33704-4300

Phone

(727) 894-0500

NPI assigned

Jun 24, 2013

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

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andrew Rothberg OD PAGroup PAC ID 1355563362, 3 clinicians

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 and National Provider Directory roles.

• Andrew Rothberg OD PA

  • Optometrist
  • Tampa, FL
  • NPI 1881095545
  Medicare reassignment Care Compare group NPD
• Jennifer L Manning OD PA

  • Optometrist
  • Pinellas Park, FL
  • NPI 1932477650
  NPD (past)

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537574400000",
    "number": "1609215557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 4TH ST N",
            "address_2": "STE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044300",
            "telephone_number": "806-433-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 4TH ST N",
            "address_2": "STE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044300",
            "telephone_number": "727-894-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "KAITLYN",
        "middle_name": "CEZANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2018-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8258-T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Ross
• Ryan G Ross, PA-C
• Lisa Michelle Rossbach
• Christopher Rossetti
• Michael Roth
• Scott Rothenberg
• Julie Lynne Rothfeld, LMNC, NCC
• Allan Warren Rothschild, D.P.M.
• Stephen Alexander Rottgers, M.D.
• Adrienne Rouan, BS, CTTS

• Optometrist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2018; 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.