NPIMap

Organization Active NPI

Southeast Eye Institute, PA

  • Ophthalmology Physician
  • St Petersburg, FL
National Provider Identifier
1104585579
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SOUTHEAST EYE INSTITUTE, PA
Practice address
4359 35TH St N
St Petersburg, FL 33714-3717
Phone
(727) 525-3959
Fax
(727) 914-8610
NPI assigned
Dec 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Nathan Emery, MD
Title
Owner/Director
Phone
(727) 541-4469

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4359 35TH St N
St Petersburg, FL 33714-3717

Mailing address

4359 35TH St N
Pinellas Park, FL 33714-3717
Phone (727) 525-3959

Other names 2

  • Opti-mart Doing business as
  • Southeast Eye Institute d/b/a Eye Associates of Pinellas of Seminole Other name

National Provider Directory

National Provider Directory
Tax ID family
Opti-Mart10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1104585579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4359 35TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337143717",
            "telephone_number": "727-525-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4359 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143717",
            "telephone_number": "727-525-3959",
            "fax_number": "727-914-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST EYE INSTITUTE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "EMERY",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "727-541-4469",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Opti-mart",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Eye Institute d/b/a Eye Associates of Pinellas of Seminole",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.