Mark E Kennedy, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0075020 Issued in FL

Practice address

345 Clyde Morris Blvd
Suite 330
Ormond Beach, FL 32174-3111

Phone

(386) 672-4244

Fax

(386) 672-0603

NPI assigned

May 15, 2006

Sex

Male

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 3

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Meharry Medical College School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tomoka Eye Associates PAGroup PAC ID 2163470436, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.33 of 100Reported as group

Quality

94.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tomoka Eye Associates PA

  • Ophthalmology Physician
  • Ormond Beach, FL
  • NPI 1659321214
  Medicare reassignment Care Compare group NPD
• Tomoka Eye Associates, P.a.

  dba Tomoka Optical

  • Customized Equipment (DME)
  • Port Orange, FL
  • NPI 1891747176
  NPD
• International Eye Associates P.a.

  • Ophthalmology Physician
  • Ormond Beach, FL
  • NPI 1972524023
  NPD (past)
• Maria Isabel Lopez, MD, PA

  • Medical Specialty Clinic/Center
  • Daytona Beach, FL
  • NPI 1659658771
  NPD (past)
• Tomoka Eye Associates

  • Ophthalmology Physician
  • Ormond Beach, FL
  • NPI 1124078787
  NPD (past)
• Tomoka Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Ormond Beach, FL
  • NPI 1982637492
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811948599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CLYDE MORRIS BLVD",
            "address_2": "SUITE 330",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743111",
            "telephone_number": "386-672-4244",
            "fax_number": "386-672-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CLYDE MORRIS BLVD",
            "address_2": "SUITE 330",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743111",
            "telephone_number": "386-672-4244",
            "fax_number": "386-672-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0075020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "18778423210",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2150833",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259857400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara T Keen, MS
• Stephen Keen, M.D.
• Jay A Keesling, O.D.
• Michael R Keller
• Janelle Kelley, AUD
• Kenneth B Hawthorne Jr MD PA
• Kaley Susanne Kenney
• Sandra Kent, M.ED, CCC-SLP
• Raymond A Kenzik, DDS
• Kerry a Crandall,Arnp

• Ophthalmology Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.