Carly Nicole Salomon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5703 Issued in FL

Practice address

570 Avenue K SE
Winter Haven, FL 33880-4203

Phone

(863) 401-4200

Fax

(863) 220-9912

NPI assigned

Jun 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salomon Eye Care PAGroup PAC ID 9234545393, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Salomon Eye Care PA

  • Optometrist
  • Winter Haven, FL
  • NPI 1609469352

  FL, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Orlando, FL
  • NPI 1164308771

  FL, Optometrist

  Medicare reassignment NPD
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Clearwater, FL
  • NPI 1013108091
  NPD
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Tampa, FL
  • NPI 1114012689
  NPD

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1508425679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804203",
            "telephone_number": "863-401-4200",
            "fax_number": "863-220-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804203",
            "telephone_number": "863-401-4200",
            "fax_number": "863-220-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "CARLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109739200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eva J Salamon, M.D.
• Marcues Reshay Sallie
• Alan L Sallman, M.D.
• Salomon Eye Care PA
• Brad R Salomon, OD
• Katie M Salomon, OD
• Teresa Kim Salomon, OD
• Jay S Saltzman
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC
• Linda K Salva, MD

• All providers in Winter Haven, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.