Marissa Nicotra-Barnes, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6163 Issued in FL

Practice address

5517 S Williamson Blvd Ste 310
Port Orange, FL 32128-8310

Phone

(386) 322-4304

NPI assigned

Jul 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Radiant Vision Eyecare

  • Optometrist
  • Port Orange, FL
  • NPI 1568170827
  NPD

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1295461879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BEVILLE RD",
            "address_2": "STE 606 MAILBOX 369",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-214-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 S WILLIAMSON BLVD STE 310",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288310",
            "telephone_number": "386-322-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOTRA-BARNES",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neurology & Spine Disorders LLC
• New Hope Miniistries & Counseling, Inc
• Rachel Newman
• Thomas E Nicholas, DC
• Kim A Nichols
• Cindy Nierenberg
• Emily Noltemeyer
• Jessica R. Noonan
• Heather Lynne Norman, FNP C
• Jami Norris

• Optometrist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.