Individual provider Active NPI

Kelly Lynne Catino, O.D.

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1821099656
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1857 Issued in NC
Practice address
201 Racine Dr
Wilmington, NC 28403-8702
Phone
(910) 395-6050
Fax
(910) 395-6692
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1857 NC Primary

Addresses

Primary practice location

201 Racine Dr
Wilmington, NC 28403-8702

Mailing address

8116 Market St
Ste 100
Wilmington, NC 28411-9732
Phone (910) 686-2074

Other identifiers 4

IdentifierTypeStateIssuer
410049393OtherNCRR MEDICARE INDIVIDUAL #
410049391OtherNCRR MEDICARE INDIVIDUAL #
89093MKMedicaidNC
093MKOtherNCBCBS PROV #

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090923000815 NC Practitioner - Optometry 2163574302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catino Eye Care Center OD PAGroup PAC ID 9739235359, 2 clinicians

Practice addresses (Care Compare)

8116 Market St
Suite 100
Wilmington, NC 28411-9732
Phone (910) 686-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1857NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Catino Eye Care Center OD PA Optometrist CurrentSince Jul 1, 2009 Accepting new patients

Locations

8116 Market St
Ste 100
Wilmington, NC 28411
Phone (910) 686-8000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1821099656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8116 MARKET ST",
            "address_2": "STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119732",
            "telephone_number": "910-686-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RACINE DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038702",
            "telephone_number": "910-395-6050",
            "fax_number": "910-395-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATINO",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL #",
            "identifier": "410049393",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL #",
            "identifier": "410049391",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093MK",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "093MK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.