Katherine Padinjath

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11004880 Issued in FL

Practice address

1265 E Main St
Bartow, FL 33830-5006

Phone

(863) 534-3737

Fax

(863) 533-6323

NPI assigned

Nov 4, 2019

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

Electronic endpoints 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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DHDDCA

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.

• Newlight Psychiatric Services Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakeland, FL
  • NPI 1477058691
  Medicare reassignment NPD
• Central Florida Psychotherapy Services LLC

  • Clinical Social Worker
  • Lakeland, FL
  • NPI 1689286809
  NPD
• Polk Pediatrics

  • Pediatrics Physician
  • Bartow, FL
  • NPI 1376689711
  NPD (past)

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666483200000",
    "number": "1760026652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17602 BUCKINGHAM GARDEN DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474333",
            "telephone_number": "336-567-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E MAIN ST",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338305006",
            "telephone_number": "863-534-3737",
            "fax_number": "863-533-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5302 S Florida Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338134910",
            "country_code": "US",
            "telephone_number": "863-602-7001",
            "fax_number": "863-583-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADINJATH",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2022-10-23",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD NURSING",
            "identifier": "11004880",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "referrals",
            "affiliation": "Y",
            "affiliationName": "POLK PEDIATRICS",
            "address_1": "1265 E Main St",
            "city": "Bartow",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338305006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Optomeyez Vision LLC
• Melisa Marie Ortiz Rodriguez, RN
• Fernando Ortiz, RN
• Candy C Ortutay
• Suzanne McMahon Osthoff
• David Pagan, PTA
• Palm Medical Center Lakeland LLC
• Ruth Pannebaker
• Para Z-Aid LLC
• Keith Bernard Paredes, MD

• Family Nurse Practitioner in Bartow, FL
• Providers in Bartow, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.