Individual provider Active NPI

Jessica Small Prochilo

  • Optometrist
  • Coral Springs, FL
National Provider Identifier
1760275531
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6691 Issued in FL
Practice address
2059 N University Dr
Coral Springs, FL 33071-6132
Phone
(954) 753-1100
NPI assigned
May 26, 2025
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6691 FL Primary

Addresses

Primary practice location

2059 N University Dr
Coral Springs, FL 33071-6132

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

6000 Glades Rd Ste 1116
Boca Raton, FL 33431-7294
Phone (561) 367-0900

Other practice location 2

1100 Linton Blvd Ste C7
Delray Beach, FL 33444-1146
Phone (561) 278-1116

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
I20250708004198 FL Practitioner - Optometry 8729592142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

1100 Linton Blvd
Suite C7
Delray Beach, FL 33444-1146
Phone (561) 278-1116

3011 W Yamato Rd
Suite A19
Boca Raton, FL 33434-5353
Phone (561) 995-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6691FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a. Gendal, O.D., P.a. Optometrist CurrentSince Jun 17, 2025 Accepting new patients

Locations

2059 N University Dr
Coral Springs, FL 33071
Phone (954) 752-0589

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, 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": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1760275531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 N UNIVERSITY DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716132",
            "telephone_number": "954-753-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Glades Rd Ste 1116",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334317294",
            "country_code": "US",
            "telephone_number": "561-367-0900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Linton Blvd Ste C7",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334441146",
            "country_code": "US",
            "telephone_number": "561-278-1116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL PROCHILO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.