Organization Active NPI

Tomoka Eye Associates

  • Ophthalmology Physician
  • Ormond Beach, FL
National Provider Identifier
1265482970
Registry record updated Aug 21, 2026
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
(386) 672-4244
Fax
(386) 672-0603
NPI assigned
May 11, 2006
Last updated
Aug 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Authorized official

Name
Lee Howard Shollenberger
Title
Ceo
Phone
(386) 506-8400

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

21 Hospital Dr Ste 160
Palm Coast, FL 32164-2454
Phone (386) 586-3711

Other identifiers 1

IdentifierTypeStateIssuer
256352501MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000735 FL Part B Supplier - Clinic/Group Practice 2163470436 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ormond Beach, FL; Port Orange, FL; Palm Coast, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1265482970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR STE 160",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642454",
            "telephone_number": "386-586-3711",
            "fax_number": "386-586-3788"
        },
        {
            "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": "386-672-4244",
            "fax_number": "386-672-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMOKA EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "SHOLLENBERGER",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-506-8400"
    },
    "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": "256352501",
            "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 Aug 21, 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.