Individual provider Active NPI

Jilma H Ellison, O.D.

  • Corneal and Contact Management Optometrist
  • Oviedo, FL
National Provider Identifier
1447364492
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OPC4126 Issued in FL
Practice address
3607 Aloma Ave Ste 1081
Oviedo, FL 32765-8811
Phone
(407) 678-9151
Fax
(321) 682-7299
NPI assigned
Aug 18, 2006
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OPC4126 FL Primary

Addresses

Primary practice location

3607 Aloma Ave Ste 1081
Oviedo, FL 32765-8811

Mailing address

3635 Aloma Ave
Ste 1029
Oviedo, FL 32765-6395
Phone (407) 678-9151

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
I20070829000117 FL Practitioner - Optometry 9931291416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Eye Associates LLCGroup PAC ID 0840321279, 2 clinicians

Practice addresses (Care Compare)

3607 Aloma Ave
Suite 1081
Oviedo, FL 32765-8811
Phone (407) 678-9151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Eye Associates LLC CurrentSince Apr 30, 2003 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients
Trinity Visual and Neurological Rehabilitation Center Past Accepting new patients

Locations

3607 Aloma Ave
Ste 1081
Oviedo, FL 32765
Phone (407) 678-9151

3635 Aloma Ave
Ste 1029
Oviedo, FL 32765
Phone (407) 678-9151

1311 Sundial Pt
Winter Springs, FL 32708
Phone (321) 888-3325

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1447364492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 ALOMA AVE",
            "address_2": "STE 1029",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656395",
            "telephone_number": "407-678-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 ALOMA AVE STE 1081",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658811",
            "telephone_number": "407-678-9151",
            "fax_number": "321-682-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JILMA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC4126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.