Individual provider Active NPI

Thara Abu-Mallouh, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1790455095
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6013 Issued in FL
Practice address
7205 Bentley Rd
Jacksonville, FL 32256-7565
Phone
(904) 296-0098
Fax
(904) 861-3899
NPI assigned
Sep 17, 2021
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 OPC6013 FL Primary

Addresses

Primary practice location

7205 Bentley Rd
Jacksonville, FL 32256-7565

Mailing address

PO Box 11407
Birmingham, AL 35246-8575
Phone (864) 359-1308

Other practice location 1

12341 Yellow Bluff Rd Ste 4
Jacksonville, FL 32226-2014
Phone (904) 296-0098

Other practice location 2

206 Ashourian Ave Ste 215
St Augustine, FL 32092-5107
Phone (904) 296-0098

Other practice location 3

3 Shircliff Way Ste 134
Jacksonville, FL 32204-4785
Phone (239) 466-2020

Other practice location 4

1909 Beach Blvd Ste 101
Jacksonville Beach, FL 32250-2643
Phone (941) 792-2020

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
I20210922001457 FL Practitioner - Optometry 8123425873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of Manatee, LLPGroup PAC ID 4688664535, 60 clinicians

Practice addresses (Care Compare)

12341 Yellow Bluff Rd
Suite 4
Jacksonville, FL 32226-2014
Phone (904) 296-0098

Merit-based Incentive Payment System (MIPS)

Final score
89.23 of 100Reported as group
Quality
97.49
Improvement activities
40
Cost
67.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Frank W. Bowden, III, MD, Facs, PA CurrentSince Sep 20, 2021 Accepting new patients
Eye Associates of Manatee, LLP CurrentSince Mar 1, 2025 Accepting new patients
Eye Associates of Manatee LLP CurrentSince Mar 1, 2025 Accepting new patients
Frank W Bowden III MD Facs PA Optometrist CurrentSince Sep 20, 2021 Accepting new patients

Locations

6002 Pointe West Blvd
Bradenton, FL 34209
Phone (941) 792-3937

12341 Yellow Bluff Rd
Ste 4
Jacksonville, FL 32226
Phone (904) 296-0098

7205 Bentley Rd
Jacksonville, FL 32256
Phone (904) 296-0098

1909 Beach Blvd
Ste 101
Jax Bch, FL 32250
Phone (904) 247-5575

206 Ashourian Ave
Ste 215
St Augustine, FL 32092
Phone (904) 296-0098

Interoperability endpoints

  • Direct secure messaging: thara.abumallouh.p1@direct.theeyeassociates.nextgenshare.com

Organizations & group practices 4

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": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1790455095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468575",
            "telephone_number": "864-359-1308",
            "fax_number": "239-496-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 BENTLEY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567565",
            "telephone_number": "904-296-0098",
            "fax_number": "904-861-3899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12341 Yellow Bluff Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322262014",
            "country_code": "US",
            "telephone_number": "904-296-0098",
            "fax_number": "904-696-3422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 Ashourian Ave Ste 215",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320925107",
            "country_code": "US",
            "telephone_number": "904-296-0098",
            "fax_number": "904-346-0559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Shircliff Way Ste 134",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044785",
            "country_code": "US",
            "telephone_number": "239-466-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1909 Beach Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322502643",
            "country_code": "US",
            "telephone_number": "941-792-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABU-MALLOUH",
        "first_name": "THARA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.