Organization Active NPI

Nicole Cremata OD PA

  • Optometrist
  • Key West, FL
National Provider Identifier
1770856239
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NICOLE CREMATA OD PA
Practice address
3202 N Roosevelt Blvd
Key West, FL 33040-4114
Phone
(305) 296-5020
NPI assigned
Feb 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nichole G Cremata
Title
Owner
Phone
(305) 296-5020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3202 N Roosevelt Blvd
Key West, FL 33040-4114

Mailing address

3202 N Roosevelt Blvd
Key West, FL 33040-4114
Phone (305) 296-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120221000760 FL Part B Supplier - Clinic/Group Practice 6507024627 Receives reassigned benefits from 2 practitioners
Practice locations: Marathon, FL

National Provider Directory

National Provider Directory

Locations

3202 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 292-4212

5800 Overseas Hwy
Ste 43
Marathon, FL 33050
Phone (305) 743-5533

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1770856239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404114",
            "telephone_number": "305-296-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404114",
            "telephone_number": "305-296-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE CREMATA OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "CREMATA",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-296-5020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.