Individual provider Active NPI

Molly Dara Wiles, OD

  • Optometrist
  • Pinellas Park, FL
National Provider Identifier
1861485443
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5635 Issued in FL
Practice address
4010 Park Blvd N
Pinellas Park, FL 33781-3633
Phone
(727) 369-4290
NPI assigned
Aug 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5635 FL Primary

Addresses

Primary practice location

4010 Park Blvd N
Pinellas Park, FL 33781-3633

Mailing address

1919 Oxford St N
Saint Petersburg, FL 33710-4954
Phone (727) 272-0449

Other names 1

  • Dr. Molly Dara Carren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120510000053 MD Practitioner - Optometry 3678753860 Reassigns benefits to 1 organization
I20200423001147 FL Practitioner - Optometry 3678753860 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Jun 1, 2020 Accepting new patients
Sightrite Medical FL PLLC Optometrist CurrentSince Mar 1, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. PastSince Apr 26, 2020 Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4001 1st St E
Bradenton, FL 34208
Phone (941) 745-9800

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

17781 Thelma Ave
Jupiter, FL 33458
Phone (561) 746-2998

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

1725 W Mlk Blvd
Tampa, FL 33607
Phone (239) 800-1717

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

267 Broadway
Brooklyn, NY 11211

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1861485443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 OXFORD ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337104954",
            "telephone_number": "727-272-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813633",
            "telephone_number": "727-369-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "MOLLY",
        "middle_name": "DARA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "CARREN",
            "middle_name": "DARA",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.