Individual provider Active NPI

Scot Corbin Holman, M.D.

  • Ophthalmology Physician
  • Tavares, FL
National Provider Identifier
1467533505
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME98150 Issued in FL
Practice address
3310 Waterman Way
Tavares, FL 32778-5250
Phone
(352) 343-2020
Fax
(352) 343-4728
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME98150 FL Primary

Addresses

Primary practice location

3310 Waterman Way
Tavares, FL 32778-5250

Mailing address

3310 Waterman Way
Tavares, FL 32778-5250
Phone (352) 343-2020

Other identifiers 1

IdentifierTypeStateIssuer
278933700MedicaidFL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071018000385 FL Practitioner - Ophthalmology 0547356875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Tennessee, HSC, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1852 Mayo Dr
Tavares, FL 32778-4320
Phone (352) 343-2020

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME98150FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Premier Eye Associates Ophthalmology CurrentSince Jul 23, 2007 Accepting new patients
Santa Fe Surgery Center LLC CurrentSince Jul 23, 2007 Accepting new patients

Locations

601 E Dixie Ave
Ste 201
Leesburg, FL 34748
Phone (352) 253-5961

1852 Mayo Dr
Tavares, FL 32778
Phone (352) 343-2020

3310 Waterman Way
Tavares, FL 32778
Phone (352) 343-1216

1400 N US Highway 441
Ste 521
The Villages, FL 32159
Phone (352) 253-5961

5431 E State Road 44
Ste 1
Wildwood, FL 34785
Phone (352) 360-6261

5431 E State Road 44
Wildwood, FL 34785
Phone (352) 632-2020

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1467533505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-343-2020",
            "fax_number": "352-343-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-343-2020",
            "fax_number": "352-343-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "SCOT",
        "middle_name": "CORBIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME98150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278933700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.