NPIMap

Organization Active NPI

Tomoka Eye Associates, P.a.

Doing business as Tomoka Optical

  • Customized Equipment (DME)
  • Port Orange, FL
National Provider Identifier
1891747176
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
TOMOKA EYE ASSOCIATES, P.A.
Doing business as
Tomoka Optical
Practice address
790 Dunlawton Ave
Suite a
Port Orange, FL 32127-4222
Phone
(386) 767-0053
Fax
(386) 767-3490
NPI assigned
May 16, 2006
Last updated
Aug 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Authorized official

Name
Lee Howard Shollenberger
Title
Ceo
Phone
(386) 506-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

790 Dunlawton Ave
Suite a
Port Orange, FL 32127-4222

Mailing address

790 Dunlawton Ave Ste a
Port Orange, FL 32127-4222
Phone (386) 767-0053

Other names 1

  • Tomoka Optical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930078906 FL DME Supplier - Physician - OptometristDME Supplier - Optician 2163470436 Practice locations: Port Orange, FL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2113324Tomoka Eye Associates790 Dunlawton Ave Ste a, Port Orange, FL 32127Certificate of waiverMay 18, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Tomoka Optical790 Dunlawton Ave, Port Orange, FL 32127-4222(386) 760-9939 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Tomoka Eye Associates PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

802 Sterthaus Dr
Ormond Beach, FL 32174
Phone (386) 672-4244

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1891747176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 DUNLAWTON AVE STE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274222",
            "telephone_number": "386-767-0053",
            "fax_number": "386-767-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 DUNLAWTON AVE",
            "address_2": "SUITE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274222",
            "telephone_number": "386-767-0053",
            "fax_number": "386-767-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMOKA EYE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "SHOLLENBERGER",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-506-8400"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tomoka Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tomoka Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.