Active NPI
Tomoka Eye Associates, P.a.
- Customized Equipment (DME)
- Palm Coast, FL
National Provider Identifier
1376595835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 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 |
|---|---|---|---|
| 10D2113325 | Tomoka Eye Associates | Certificate of waiver | May 18, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Tomoka Eye Associates
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Ormond Beach, FL
- NPI 1124078787
-
- Customized Equipment (DME)
- Ormond Beach, FL
- NPI 1629020961
-
- Ophthalmology Physician
- Ormond Beach, FL
- NPI 1659321214
-
- Customized Equipment (DME)
- Port Orange, FL
- NPI 1891747176
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.