Active NPI
Columbia Eye Associates PA
- Ophthalmology Physician
- Lake City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME78478
- Legal business name
- COLUMBIA EYE ASSOCIATES PA
- Practice address
- 1615 SW Main Blvd
Lake City, FL 32025-1108 - Phone
- (386) 755-2785
- Fax
- (386) 755-1128
- NPI assigned
- Sep 15, 2007
- Last updated
- Apr 10, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Karl Bodendorfer, MD
- Title
- Owner
- Phone
- (386) 755-2785
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME78478 | FL | Primary |
Addresses
Primary practice location
1615 SW Main Blvd
Lake City, FL 32025-1108
Mailing address
PO Box 489
Lake City, FL 32056-0489
Phone (386) 755-2785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040405001839 | FL | Part B Supplier - Clinic/Group Practice | 7517950637 |
Receives reassigned benefits from 10 practitioners Practice locations: Alachua, FL; Gainesville, FL; Lake City, FL; Live Oak, FL |
| O20100930005696 | FL | DME Supplier - Physician - Ophthalmology | 7517950637 |
1 other NPI on this enrollment Practice locations: Lake City, FL |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2284846 | Columbia Eye Associates PA | Certificate of waiver | Jun 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
14480 NW 152nd Ln
Alachua, FL 32615
Phone (352) 792-1610
14482 NW 152ND LN
Alachua, FL 32615
265 SW Malone St
Ste 111
Lake City, FL 32025
Phone (386) 755-5699
105 Grand St NE
Live Oak, FL 32064
Phone (386) 364-5677
4550 Clyde Morris Blvd
Port Orange, FL 32129
Interoperability endpoints
- amurphy@ceapa.intellechartdirect.net
- csingleton@ceapa.intellechartdirect.net
- csweeney@ceapa.intellechartdirect.net
- eboone@ceapa.intellechartdirect.net
- https://app.meldrx.com/api/fhir/K8KD7A7C
- kbodendorfer@ceapa.intellechartdirect.net
- mshenouda@ceapa.intellechartdirect.net
- nkhuddus@ceapa.intellechartdirect.net
- wavonda@ceapa.intellechartdirect.net
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Ophthalmology Physician
- Lake City, FL
- NPI 1205947959
-
- Optometrist
- Lake City, FL
- NPI 1710919170
-
- Optometrist
- Lake City, FL
- NPI 1437188562
-
- Ophthalmology Physician
- Gainesville, FL
- NPI 1124069505
-
- Optometrist
- Gainesville, FL
- NPI 1023314382
-
- Ophthalmology Physician
- Lake City, FL
- NPI 1104801976
-
- Ophthalmology Physician
- Lake City, FL
- NPI 1255425260
-
- Ophthalmology Physician
- Gainesville, FL
- NPI 1588624407
-
- Optometrist
- Gainesville, FL
- NPI 1225126022
-
- Ophthalmology Physician
- Lake City, FL
- NPI 1316922669
-
- Ophthalmology Physician
- Lake City, FL
- NPI 1891323465
-
- Optometrist
- Lake City, FL
- NPI 1942351218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189814400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744243200000",
"number": "1295921096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 489",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320560489",
"telephone_number": "386-755-2785",
"fax_number": "386-755-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 SW MAIN BLVD",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320251108",
"telephone_number": "386-755-2785",
"fax_number": "386-755-1128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLUMBIA EYE ASSOCIATES PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-15",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A",
"authorized_official_last_name": "BODENDORFER",
"authorized_official_first_name": "KARL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "386-755-2785",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME78478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake City, FL
- Columbia County Schools
- Columbia County Senior Services
- Columbia County Senior Services
- Columbia Emergency Group LLC
- Columbia Emergency Services Inc
- Tracy Combee
- Come on Home to Rosa's Place, LLC
- Comfortable Care Dental Health Professionals, PA (Complete Dental of Lake City)
- Comfortcare Delight, LLC
- Concierge Home Care of Lake City LLC (Concierge Home Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.