COLUMBIA EYE ASSOCIATES PA
NPI 1295921096
Ophthalmology in Lake City, FL
About Columbia Eye Associates Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COLUMBIA EYE ASSOCIATES PA (NPI 1295921096) is a healthcare organization registered as an ophthalmology in Lake City, Florida and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Karl Bodendorfer, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Columbia Eye Associates Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
11Medicare enrollment records show 11 clinicians reassign Medicare billing to Columbia Eye Associates PA, which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (11)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2284846
Columbia Eye Associates PA · Lake City, FLFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Columbia Eye Associates PA's NPI number?
The NPI number for Columbia Eye Associates PA is 1295921096. It was assigned to this organization in the NPPES registry on September 15, 2007.
Where is Columbia Eye Associates PA located?
Columbia Eye Associates PA is located at 1615 SW Main Blvd, Lake City, FL 32025. The listed phone number is (386) 755-2785.
What is Columbia Eye Associates PA's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Columbia Eye Associates PA enrolled in Medicare?
Yes. Columbia Eye Associates PA is registered in the Medicare PECOS enrollment system.
When is Columbia Eye Associates PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Florida, Physician - Ophthalmology) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Columbia Eye Associates PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 2 Medicare specialties reassign their Medicare billing to Columbia Eye Associates PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Ophthalmology (7) and Optometry (4). Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Columbia Eye Associates PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2284846) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Columbia Eye Associates PA accept?
Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Anthem Blue Cross and Blue Shield and AvMed and 5 other insurers list Columbia Eye Associates PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Columbia Eye Associates PA was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Columbia Eye Associates Pa · NPI 1295921096
Ophthalmology organization in Lake City, Florida. Organization record, active in the CMS NPPES registry since September 15, 2007.
## Identity
- **NPI:** 1295921096 (Entity type: Organization)
- **Enumerated:** September 15, 2007
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **Organization subpart:** No
- **Authorized official:** Karl Bodendorfer, OWNER
## Practice location
- **Address:** 1615 SW MAIN BLVD, Lake City, FL 32025-1108
- **Phone:** (386) 755-2785 · **Fax:** (386) 755-1128
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (DME, Florida, Physician - Ophthalmology) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 11 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Ophthalmology (7), Optometry (4); 7 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 10, 2025
- **Other identifiers:** Other DB1077 (FL); Medicaid 001933700 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295921096) · Data from the CMS NPPES public registry.