Individual provider Active NPI

Tomas Alejandro Moreno, MD

  • Ophthalmology Physician
  • Jacksonville, FL
National Provider Identifier
1184967341
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME139693 Issued in FL
Practice address
8786 Perimeter Park Blvd
Jacksonville, FL 32216-6347
Phone
(904) 997-9202
Fax
(904) 997-9205
NPI assigned
Apr 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X ME139693 FL
Ophthalmology Physician 207W00000X ME139693 FL Primary

Addresses

Primary practice location

8786 Perimeter Park Blvd
Jacksonville, FL 32216-6347

Mailing address

8786 Perimeter Park Blvd
Jacksonville, FL 32216-6347
Phone (904) 997-9202

Other practice location 1

1100 Plantation Island Dr S Ste 130
St Augustine, FL 32080-5173
Phone (904) 829-0663

Other practice location 2

800 Zeagler Dr Ste 310
Palatka, FL 32177-3827
Phone (386) 325-2411

Other practice location 3

3120 Glynn Ave
Brunswick, GA 31520-4848
Phone (912) 262-9092

Other practice location 4

304 Riverside Dr
Waycross, GA 31501-4549
Phone (912) 283-1400

Other identifiers 2

IdentifierTypeStateIssuer
102472300MedicaidFL
003217747AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmoreno@floridaretinainstitute.intellechartdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190514001127 FL Practitioner - Ophthalmology 7810291101 Reassigns benefits to 1 organization
I20190613001997 GA Practitioner - Ophthalmology 7810291101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Duke University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Vitreous ConsultantsGroup PAC ID 4082610019, 43 clinicians

Practice addresses (Care Compare)

3120 Glynn Ave
Brunswick, GA 31520-4848
Phone (912) 262-9092

8786 Perimeter Park Blvd
Jacksonville, FL 32216-6347
Phone (904) 997-9202

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME139693FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Vitreous Consultants Ophthalmology CurrentSince Oct 1, 2023 Accepting new patients

Locations

950 Glades Rd
Ste 1C
Boca Raton, FL 33431
Phone (305) 294-5504

8786 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (904) 997-9202

2639 Oak St
Jacksonville, FL 32204
Phone (904) 387-5600

95 Columbia St
Orlando, FL 32806
Phone (407) 849-9621

800 Zeagler Dr
Ste 310
Palatka, FL 32177
Phone (386) 325-2411

50 Leanni Way
Unit E5
Palm Coast, FL 32137
Phone (386) 447-1847

1100 Plantation Island Dr S
Ste 130
Saint Augustine, FL 32080
Phone (904) 826-0663

1370 E Venice Ave
Ste 201
Venice, FL 34285
Phone (941) 480-0500

3120 Glynn Ave
Brunswick, GA 31520
Phone (912) 262-9092

304 Riverside Dr
Waycross, GA 31501
Phone (912) 283-1400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1184967341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8786 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166347",
            "telephone_number": "904-997-9202",
            "fax_number": "904-997-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8786 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166347",
            "telephone_number": "904-997-9202",
            "fax_number": "904-997-9205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Plantation Island Dr S Ste 130",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320805173",
            "country_code": "US",
            "telephone_number": "904-829-0663",
            "fax_number": "904-826-0664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Zeagler Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321773827",
            "country_code": "US",
            "telephone_number": "386-325-2411",
            "fax_number": "386-325-2499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3120 Glynn Ave",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315204848",
            "country_code": "US",
            "telephone_number": "912-262-9092",
            "fax_number": "912-466-0639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "304 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315014549",
            "country_code": "US",
            "telephone_number": "912-283-1400",
            "fax_number": "912-283-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "TOMAS",
        "middle_name": "ALEJANDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-05",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME139693",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME139693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102472300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003217747A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmoreno@floridaretinainstitute.intellechartdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8786 Perimeter Park Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322166347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.