Individual provider Active NPI

Scott M. Pearl, O.D.

  • Optometrist
  • St Augustine, FL
National Provider Identifier
1467452474
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC001954 Issued in FL
Practice address
535 Los Caminos St
St Augustine, FL 32095-7417
Phone
(954) 655-8330
NPI assigned
Aug 1, 2005
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC001954 FL Primary

Addresses

Primary practice location

535 Los Caminos St
St Augustine, FL 32095-7417

Mailing address

535 Los Caminos St
St Augustine, FL 32095-7417
Phone (954) 655-8330

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
I20050512000296 FL Practitioner - Optometry 7618917303 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC001954FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Feb 18, 2019 Accepting new patients
Kennedy Vision PA Optometrist CurrentSince Apr 30, 2013 Accepting new patients
Aeg Florida Professional PLLC Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Bartram Vision Care Optometrist CurrentSince Jun 10, 2025 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Feb 18, 2019 Accepting new patients

Locations

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

18503 Pines Blvd
Ste 205
Pembroke Pines, FL 33029
Phone (954) 430-8330

1185 Saint Johns Pkwy
Ste 4
St Johns, FL 32259
Phone (904) 686-1420

450 State Road 13 N
Ste 107
St Johns, FL 32259
Phone (904) 287-3387

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 893-4005

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1467452474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 LOS CAMINOS ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320957417",
            "telephone_number": "954-655-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 LOS CAMINOS ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320957417",
            "telephone_number": "954-655-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARL",
        "first_name": "SCOTT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.