Individual provider Active NPI

Nicholas Whiting, OD

  • Optometrist
  • Vero Beach, FL
National Provider Identifier
1366066771
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5823 Issued in FL
Practice address
3500 US Highway 1
Vero Beach, FL 32960-4511
Phone
(772) 299-1404
Fax
(772) 299-1455
NPI assigned
Jun 1, 2020
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5823 FL Primary

Addresses

Primary practice location

3500 US Highway 1
Vero Beach, FL 32960-4511

Mailing address

3500 US Highway 1
Vero Beach, FL 32960-4511

Other practice location 1

580 W 8th St
Tower 2, 3rd Floor
Jacksonville, FL 32209
Phone (904) 244-9390

Other practice location 2

2215 Nebraska Ave Ste 2-H
Fort Pierce, FL 34950-4866
Phone (772) 410-2810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716001371 FL Practitioner - Optometry 2860816444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William J. Mallon, MDGroup PAC ID 9234039116, 10 clinicians

Practice addresses (Care Compare)

3500 US Hwy 1
Vero Beach, FL 32960-4511
Phone (772) 299-1404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5823FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 20, 2020 Accepting new patients
William J. Mallon, MD CurrentSince Oct 16, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 20, 2020 Accepting new patients

Locations

2215 Nebraska Ave
Ste 2-H
Fort Pierce, FL 34950
Phone (772) 410-2810

580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960

580 W 8th St
Fl 3
Jacksonville, FL 32209
Phone (904) 244-9390

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

3500 US Highway 1
Vero Beach, FL 32960
Phone (772) 202-6625

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1366066771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604511",
            "telephone_number": "772-299-1404",
            "fax_number": "772-299-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 W 8th St",
            "address_2": "Tower 2, 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32209",
            "country_code": "US",
            "telephone_number": "904-244-9390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Nebraska Ave Ste 2-H",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504866",
            "country_code": "US",
            "telephone_number": "772-410-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITING",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.