NPIMap

Organization Active NPI

Tomoka Eye Associates

  • Ophthalmology Physician
  • Ormond Beach, FL
National Provider Identifier
1124078787
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TOMOKA EYE ASSOCIATES
Practice address
345 Clyde Morris Blvd
Suite 330
Ormond Beach, FL 32174-3111
Phone
(376) 672-4244
Fax
(386) 672-0603
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Allison Kern
Title
Office/Billing Manager
Phone
(386) 506-8403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

345 Clyde Morris Blvd
Suite 330
Ormond Beach, FL 32174-3111

Mailing address

790 Dunlawton Ave
Suite a
Port Orange, FL 32127-9279
Phone (376) 767-0053

Other identifiers 1

IdentifierTypeStateIssuer
256352503MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Tomoka Eye Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

790 Dunlawton Ave
Ste A
Port Orange, FL 32127
Phone (386) 506-8403

Practitioners & affiliated clinicians

Practitioners 8

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1124078787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 DUNLAWTON AVE",
            "address_2": "SUITE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279279",
            "telephone_number": "376-767-0053",
            "fax_number": "386-767-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CLYDE MORRIS BLVD",
            "address_2": "SUITE 330",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743111",
            "telephone_number": "376-672-4244",
            "fax_number": "386-672-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMOKA EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OFFICE/BILLING MANAGER",
        "authorized_official_telephone_number": "386-506-8403"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256352503",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 6, 2020; 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.