NPIMap

Organization Active NPI

Dr. Jason Iannarelli P.a.

  • Optometrist
  • Ormond Beach, FL
National Provider Identifier
1083972640
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3902 Issued in FL
Legal business name
DR. JASON IANNARELLI P.A.
Practice address
1400 Hand Avenue
Unit N
Ormond Beach, FL 32174
Phone
(386) 872-3111
Fax
(386) 872-3190
NPI assigned
May 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Dr. Jason E Iannarelli, O.D.NPI 1073551206
Title
Owner
Phone
(386) 872-3111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC3902 FL Primary

Addresses

Primary practice location

1400 Hand Avenue
Unit N
Ormond Beach, FL 32174

Mailing address

1400 Hand Avenue
Unit N
Ormond Beach, FL 32174
Phone (386) 872-3111

Other names 1

  • Dr. Eye Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120503000572 FL Part B Supplier - Clinic/Group Practice 7113189358 Receives reassigned benefits from 4 practitioners
Practice locations: Ormond Beach, FL; Port Orange, FL

National Provider Directory

National Provider Directory

Locations

268 N Nova Rd
Ormond Beach, FL 32174
Phone (386) 675-6599

1400 Hand Ave
Ste N
Ormond Beach, FL 32174
Phone (386) 290-9493

5140 S Clyde Morris Blvd
Unit 4
Port Orange, FL 32127
Phone (386) 265-1970

1633 Taylor Rd
Unit 104
Port Orange, FL 32128
Phone (386) 256-3510

1633 Taylor Rd
#104
Port Orange, FL 32128
Phone (386) 256-3510

Practitioners & affiliated clinicians

Practitioners 6

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": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1083972640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HAND AVENUE",
            "address_2": "UNIT N",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-872-3111",
            "fax_number": "386-872-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HAND AVENUE",
            "address_2": "UNIT N",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-872-3111",
            "fax_number": "386-872-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JASON IANNARELLI P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "IANNARELLI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-872-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.