Kristine Thao Sam, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5446 Issued in FL

Practice address

703 N Main St
Kissimmee, FL 34744-5265

Phone

(504) 355-6026

NPI assigned

Jul 19, 2017

Last updated

Mar 17, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Vision LLC

  • Optometrist
  • Kissimmee, FL
  • NPI 1841706934
  Authorized official Same address or phone

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902329238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 VALLEYVIEW DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462895",
            "telephone_number": "504-355-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445265",
            "telephone_number": "504-355-6026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 W Osceola Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347417565",
            "country_code": "US",
            "telephone_number": "407-870-0443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "KRISTINE",
        "middle_name": "THAO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christi Salter
• Saltzman, Tanis, Pittel, Levin and Jacobson, LLC (Pediatric Associates)
• Saltzman, Tanis, Pittel, Levin and Jacobson, LLC (Pediatric Associates)
• Ivette Salvat Rodriguez, RBT
• Cara Salvati
• Sam's Club Optical (Sam's Club Optical 30-4782)
• Muhammad Sameed
• Wendy A Samms-Farmer
• Madiu Samper
• Janecia Sampson

• Optometrist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.