NPIMap

Organization Active NPI

Atlantic Eye Institute P.a.

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
National Provider Identifier
1376685404
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ATLANTIC EYE INSTITUTE P.A.
Practice address
6207 Bennett Rd
Jacksonville, FL 32216-5007
Phone
(904) 731-4515
NPI assigned
Feb 13, 2007
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ATLANTIC EYE INSTITUTE P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Neil T Shmunes, M.D.NPI 1518068329
Title
President
Phone
(904) 241-7865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6207 Bennett Rd
Jacksonville, FL 32216-5007

Mailing address

6207 Bennett Rd
Jacksonville, FL 32216-5007
Phone (904) 731-4515

Other names 1

  • Atlantic Optical Southside Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930053593 FL DME Supplier - Physician - Ophthalmology 2466434386 Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Eye Institute PA5 organizations share this tax ID, including this one
Part of
Atlantic Eye Institute PA

Other organizations with this tax ID 4

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

Locations

105 Nature Walk Pkwy
Unit 105
St Augustine, FL 32092
Phone (904) 241-7865

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1376685404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 BENNETT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165007",
            "telephone_number": "904-731-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6207 BENNETT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165007",
            "telephone_number": "904-731-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC EYE INSTITUTE P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC EYE INSTITUTE P.A.",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "SHMUNES",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-241-7865",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Optical Southside",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.