NPIMap

Organization Active NPI

Star Medical FL PLLC

  • Optometrist
  • Ormond Beach, FL
National Provider Identifier
1164129409
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
STAR MEDICAL FL PLLC
Practice address
900 W Granada Blvd Ste 1
Ormond Beach, FL 32174-5941
Phone
(386) 675-6599
NPI assigned
Feb 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Kelley Kott
Title
RCM Manager
Phone
(256) 795-2559

Specialties & licenses 1

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

Addresses

Primary practice location

900 W Granada Blvd Ste 1
Ormond Beach, FL 32174-5941

Mailing address

110 College St Ste E
Athens, AL 35611-2714

Other names 1

  • InFocus Eyecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230928002559 FL Part B Supplier - Clinic/Group Practice 7113385444 Receives reassigned benefits from 21 practitioners
Practice locations: Winter Park, FL; Jacksonville, FL; Sarasota, FL; Ponte Vedra Beach, FL; Ormond Beach, FL; Orlando, FL; Miami Beach, FL; Juno Beach, FL…

National Provider Directory

National Provider Directory
Tax ID family
Star Medical FL PLLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

4871 Town Center Pkwy
Ste 5
Jacksonville, FL 32246
Phone (904) 686-1386

14050 US Highway 1
Ste E
Juno Beach, FL 33408
Phone (561) 508-7651

12715 Pegasus Dr
Orlando, FL 32816
Phone (407) 758-5735

312 N Park Ave
Winter Park, FL 32789
Phone (407) 644-5156

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1164129409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLLEGE ST STE E",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W GRANADA BLVD STE 1",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745941",
            "telephone_number": "386-675-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR MEDICAL FL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "KOTT",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "256-795-2559"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InFocus Eyecare",
            "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, 2026; 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.