Mari Shelly Holderby, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4915 Issued in FL

Practice address

7912 Forest City Rd
Orlando, FL 32810-2907

Phone

(407) 905-8827

Fax

(321) 221-2047

NPI assigned

Jul 14, 2014

Last updated

Apr 28, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Florida Premier Eye AssociatesGroup PAC ID 7618914664, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mholderby@useye.intellechartdirect.net

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.

• Central Florida Premier Eye Associates

  dba Lake Eye Associates

  • Ophthalmology Physician
  • Tavares, FL
  • NPI 1013956986
  Medicare reassignment Care Compare group NPD
• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  Medicare reassignment NPD
• Community Health Centers, Inc

  • Community/Retail Pharmacy
  • Apopka, FL
  • NPI 1134258684
  Medicare reassignment NPD
• Center for Sight, PL

  • Ophthalmology Physician
  • Venice, FL
  • NPI 1386718468

  Optometrist

  NPD
• Community Health Centers, Inc

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1396829677
  NPD
• Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1710259965
  NPD
• Community Health Centers, Inc

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1831273119
  NPD
• Santa Fe Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Lady Lakes, FL
  • NPI 1518264332
  NPD
• Shaw Eye Care Associates

  dba Eye Care Center of Ocala

  • Optometrist
  • Ocala, FL
  • NPI 1316177017
  NPD

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1881001626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "321-221-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7912 FOREST CITY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102907",
            "telephone_number": "407-905-8827",
            "fax_number": "321-221-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERBY",
        "first_name": "MARI",
        "middle_name": "SHELLY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012769900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Elizabeth Holdaway, APRN
• Holden Dental Associates, Inc.
• Holden Ridge Community Living S Corp
• Tasha Shenelle Holden
• Ethel Holder, PA
• Michele Holding
• Holiday CVS LLC (CVS Pharmacy #16913)
• Holiday CVS LLC (CVS Pharmacy #05155)
• Holiday CVS LLC (CVS Pharmacy #17440)
• Holiday CVS LLC (CVS Pharmacy 07889)

• Optometrist in Orlando, FL
• Providers in Orlando, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.