Individual provider Active NPI

Katherine Susan Dunatov, O.D.

  • Optometrist
  • Bay Pines, FL
National Provider Identifier
1902111040
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002401 Issued in PA
Practice address
10000 Bay Pines Boulevard
3A-Eye Clinic
Bay Pines, FL 33744
Phone
(727) 398-6661
NPI assigned
Aug 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002401 PA Primary
Optometrist 152W00000X OPC 4563 FL

Addresses

Primary practice location

10000 Bay Pines Boulevard
3A-Eye Clinic
Bay Pines, FL 33744

Mailing address

12760 Indian Rocks Rd
Apt 410
Largo, FL 33774-2300
Phone (617) 943-0977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4563FLMDOptometrist
OEG002401PAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1902111040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 INDIAN ROCKS RD",
            "address_2": "APT 410",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337742300",
            "telephone_number": "617-943-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BOULEVARD",
            "address_2": "3A-EYE CLINIC",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNATOV",
        "first_name": "KATHERINE",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-13",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002401",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.