St Johns Eye Associates at Nocatee

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 3241 Issued in FL

Legal business name

ST JOHNS EYE ASSOCIATES AT NOCATEE

Practice address

200 Nocatee Village Drive
Ponte Vedra, FL 32081

Phone

(904) 825-4525

Fax

(904) 825-4520

NPI assigned

Aug 28, 2012

Organization subpart

No

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

Authorized official

Name

Donna Marie Backs

Title

Credentialing

Phone

(805) 433-2901

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• St Johns Eye Associates PA

  • Optometrist
  • St Augustine, FL
  • NPI 1518699065

  O20100225000113

  Same enrollment
• St Johns Eye Associates PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1609502178

  O20100225000113

  Same enrollment
• St Johns Eye Associates PA

  • Optometrist
  • St Augustine, FL
  • NPI 1710185798

  O20100225000113

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

St Johns Eye Associates at Nocatee3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• St Johns Eye Associates PA

  • Optometrist
  • St Augustine, FL
  • NPI 1518699065
  NPD tax ID
• St Johns Eye Associates PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1609502178
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diane Lynn Kapadia, OD

  • Optometrist
  • St Augustine, FL
  • NPI 1760471668
  NPD
• Sharokh Nani Kapadia, OD

  • Optometrist
  • St. Augustine, FL
  • NPI 1942299847
  NPD
• Jhaleil Phillips, OD

  • Optometrist
  • Saint Augustine, FL
  • NPI 1972111847
  NPD
• Dillon Smith, OD

  • Optometrist
  • St Augustine, FL
  • NPI 1245722917
  NPD

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1629326343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARKETSIDE AVENUE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810582",
            "telephone_number": "904-825-4525",
            "fax_number": "904-825-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NOCATEE VILLAGE DRIVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32081",
            "telephone_number": "904-825-4525",
            "fax_number": "904-825-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS EYE ASSOCIATES AT NOCATEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2022-08-19",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "BACKS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "805-433-2901"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solantic of Jacksonville, LLC
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• Valerie J Spees, DPT
• Angela Kay Stapleton-Mackenzie, M.D.
• Carol Marie Ste Claire, L.M.H.C.
• Tyson William Steele
• Lisa Jo Straight, RNCS-FNP
• Paul V Suhey, D.O.

• All providers in Ponte Vedra, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.