Organization Active NPI

Dr Mona Patel OD LLC

  • Optometrist
  • Panama City Beach, FL
National Provider Identifier
1114690336
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR MONA PATEL OD LLC
Practice address
651 Grand Panama Blvd # B1-105
Panama City Beach, FL 32407-3458
Phone
(850) 563-8800
Fax
(859) 563-8801
NPI assigned
Jul 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Mona Patel, ODNPI 1730215591
Title
Manager
Phone
(312) 890-3065

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 Primary

Addresses

Primary practice location

651 Grand Panama Blvd # B1-105
Panama City Beach, FL 32407-3458

Mailing address

651 Grand Panama Blvd Ste 104
Panama City, FL 32407-3458
Phone (850) 563-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220404000930 FL Part B Supplier - Clinic/Group Practice 5193111961 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City Beach, FL

National Provider Directory

National Provider Directory

Locations

651 Grand Panama Blvd
Ste 104
Panama City, FL 32407

651 Grand Panama Blvd
#B1105
Panama City Beach, FL 32407
Phone (850) 563-8800

651 Grand Panama Blvd
Ste 105
Panama City Beach, FL 32407
Phone (850) 563-8800

651 Grand Panama Blvd
Ste B1105
Panama City Beach, FL 32407
Phone (850) 563-8800

651 Grand Panama Blvd
Panama City Beach, FL 32407
Phone (850) 563-8800

Practitioners & affiliated clinicians

Practitioners 1

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": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1114690336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 GRAND PANAMA BLVD STE 104",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324073458",
            "telephone_number": "850-563-8800",
            "fax_number": "850-563-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 GRAND PANAMA BLVD # B1-105",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073458",
            "telephone_number": "850-563-8800",
            "fax_number": "859-563-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MONA PATEL OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-890-3065",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.