Citlalli Rosas Medina, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

6548 Issued in FL

Practice address

1225 Madison Ave
Memphis, TN 38104-2211

Phone

(901) 722-3250

NPI assigned

Jul 24, 2024

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

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Susan S Whaley OD LLCGroup PAC ID 0547536468, 4 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.

• Susan S Whaley OD LLC

  • Optometrist
  • Tallahassee, FL
  • NPI 1245750058
  Medicare reassignment Care Compare group NPD
• Susan S Whaley OD LLC

  • Optometrist
  • Tallahassee, FL
  • NPI 1790804664
  NPD
• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1851384986
  NPD (past)

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1659109387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAS MEDINA",
        "first_name": "CITLALLI",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad L Roper, PH.D.
• Sydney Nicole Roper, MD
• Shelia Rosa, CRT
• Johanna Reyna Rosales-Chavez, DO
• Gadiel Caleb Rosario Negron, RPH
• Marisol Rosas-Biser, LPC-MHSP, LMFT
• Carlo Maria Rosati, M.D.
• Rose Wound Group PLLC
• Shalanda Yvonne Rose-Snearley, LCSW
• Brandy Jo Rose, PT, DPT, CWS

• Optometrist in Memphis, TN
• Providers in Memphis, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.