Individual provider Active NPI

Hewell Eaves, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1023270378
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002459 Issued in GA
Practice address
7205 Bonneval Rd
Jacksonville, FL 32256-7565
Phone
(904) 296-0098
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002459 GA Primary
Optometrist 152W00000X OEG002051 PA

Addresses

Primary practice location

7205 Bonneval Rd
Jacksonville, FL 32256-7565

Mailing address

7205 Bonneval Rd
Jacksonville, FL 32256-7565
Phone (904) 296-0098

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000377 FL Practitioner - Optometry 5991860967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mack Eye Care PAGroup PAC ID 2567620651, 4 clinicians

Practice addresses (Care Compare)

88 Blanding Blvd
Orange Park, FL 32073-2601
Phone (904) 272-9433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002459GAMDOptometrist
OEG002051PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mack Eye Care PA Optometrist CurrentSince Nov 5, 2017 Accepting new patients

Locations

4668 Town Crossing Dr
Ste 143
Jacksonville, FL 32246
Phone (513) 765-6000

88 Blanding Blvd
Orange Park, FL 32073
Phone (904) 272-9429

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1023270378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7205 BONNEVAL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567565",
            "telephone_number": "904-296-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 BONNEVAL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567565",
            "telephone_number": "904-296-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES",
        "first_name": "HEWELL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002459",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.