NPIMap

Organization Active NPI

Karen S Wolf OD & Gil Houston OD PA

Doing business as Ponte Vedra Eye Associates

  • Optometrist
  • Ponte Vedra Beach, FL
National Provider Identifier
1598952897
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2406 Issued in FL
Legal business name
KAREN S WOLF OD & GIL HOUSTON OD PA
Doing business as
Ponte Vedra Eye Associates
Practice address
150 Professional Dr
Suite 300
Ponte Vedra Beach, FL 32082-7231
Phone
(904) 285-8448
Fax
(904) 285-3410
NPI assigned
Oct 1, 2007
Last updated
Jan 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Dr. Karen S Wolf, O.D.NPI 1154315125
Title
Owner
Phone
(904) 285-8448

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2406 FL Primary

Addresses

Primary practice location

150 Professional Dr
Suite 300
Ponte Vedra Beach, FL 32082-7231

Mailing address

150 Professional Dr
Suite 300
Ponte Vedra Beach, FL 32082-7231
Phone (904) 285-8448

Other names 1

  • Ponte Vedra Eye Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020000014 FL Part B Supplier - Clinic/Group Practice 1254392665 Receives reassigned benefits from 8 practitioners
Practice locations: Ponte Vedra Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1598952897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL DR",
            "address_2": "SUITE 300",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827231",
            "telephone_number": "904-285-8448",
            "fax_number": "904-285-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PROFESSIONAL DR",
            "address_2": "SUITE 300",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827231",
            "telephone_number": "904-285-8448",
            "fax_number": "904-285-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN S WOLF OD & GIL HOUSTON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-285-8448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponte Vedra Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.