Organization Active NPI

Tomoka Eye Associates, P.a.

  • Customized Equipment (DME)
  • Palm Coast, FL
National Provider Identifier
1376595835
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
TOMOKA EYE ASSOCIATES, P.A.
Practice address
21 Hospital Dr
Suite 160
Palm Coast, FL 32164-2454
Phone
(386) 586-3711
Fax
(386) 586-3788
NPI assigned
May 16, 2006
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
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

21 Hospital Dr
Suite 160
Palm Coast, FL 32164-2454

Mailing address

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

Other names 1

  • Tomoka Optical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930091465 FL DME Supplier - Physician - Ophthalmology 2163470436 Practice locations: Palm Coast, FL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2113325Tomoka Eye Associates21 Hospital Dr Ste 160, Palm Coast, FL 32164Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Tomoka Eye Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1376595835",
    "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": "21 HOSPITAL DR",
            "address_2": "SUITE 160",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642454",
            "telephone_number": "386-586-3711",
            "fax_number": "386-586-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMOKA EYE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "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": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tomoka Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tomoka Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Coast, 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.
  • 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.

Verify at the official NPI Registry.