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ST JOHNS EYE ASSOCIATES PA
NPI 1518699065
Optometrist in St Augustine, FL

Active since June 24, 2022CLIA 10D2085317 · Waiver
150 VILLAGE COMMONS DR STE A-102, ST AUGUSTINE, FL 32092(904) 287-9137(904) 287-9057 Get Directions Write a Review

NPPES record last updated: June 24, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About St Johns Eye Associates Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JOHNS EYE ASSOCIATES PA (NPI 1518699065) is a healthcare organization registered as an optometrist in St Augustine, Florida and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through October 9, 2028 and lists Donna Marie Backs, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1518699065
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameST JOHNS EYE ASSOCIATES PA
Location Address150 VILLAGE COMMONS DR STE A-102St Augustine, FL 32092-4545
Mailing Address161 Hampton Point Dr Ste 3St Augustine, FL 32092-3058 · (904) 287-9137 · Fax (904) 287-9057
Phone(904) 287-9137
Fax(904) 287-9057
Organization SubpartNo
Authorized OfficialDonna Marie BacksCredentialing Manager · (805) 433-2901
Enumeration DateJune 24, 2022
NPPES CertifiedJune 16, 2022
✔ NPI 1518699065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
150 VILLAGE COMMONS DR STE A-102, St Augustine, FL 32092
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St Johns Eye Associates Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to St Johns Eye Associates PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians, nearest first (11)

Gina Kubesh, OD
Optometry
NPI 1538042767
150 VILLAGE COMMONS DR STE 102
St Augustine, FL 32092
(904) 530-9802
✔ PECOS✔ Accepts MedicareSame address
Diane Kapadia, OD
Optometry
NPI 1760471668
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Sharokh Kapadia, OD
Optometry
NPI 1942299847
161-3 HAMPTON POINT DRIVE
St. Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Shawna Moinipour, O.D.
Optometry
NPI 1447091657
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Chelsea Nissinoff, OD
Optometry
NPI 1720715634
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Jhaleil Phillips, OD
Optometry
NPI 1972111847
161 HAMPTON POINT DR STE 3
Saint Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Samantha Price
Optometry
NPI 1538511993
161 HAMPTON POINT DR STE 3
Saint Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Dillon Smith, OD
Optometry
NPI 1245722917
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare7.0 mi
Ngan Kim Lam
Optometry
NPI 1407423247
200 NOCATEE VILLAGE DR
Ponte Vedra, FL 32081
(904) 825-4525
✔ PECOS✔ Accepts Medicare11 mi
Dea Opari
Optometry
NPI 1245075001
11406 SAN JOSE BLVD STE 1
Jacksonville, FL 32223
(904) 578-1981
✔ PECOS16 mi
Morgan Kickliter
Optometry
NPI 1487146635
10400 SAN JOSE BLVD STE 6
Jacksonville, FL 32257
(904) 880-1818
✔ PECOS✔ Accepts Medicare18 mi

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 10D2085317

St Johns Eye Associates · Saint Augustine, FL
Active · expires Oct 9, 2028
CLIA Number10D2085317
Laboratory TypePhysician Office
Certificate Effective DateOctober 10, 2026
Certificate Expiration DateOctober 9, 2028
Laboratory DirectorDr. Sharokh Kapadia
Laboratory Phone(904) 287-9137
Laboratory LocationSt Johns Eye Associates161-3 Hampton Point Dr, Saint Augustine, FL 32092
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently 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 St Johns Eye Associates PA's NPI number?

The NPI number for St Johns Eye Associates PA is 1518699065. It was assigned to this organization in the NPPES registry on June 24, 2022.

Where is St Johns Eye Associates PA located?

St Johns Eye Associates PA is located at 150 Village Commons Dr Ste A-102, St Augustine, FL 32092. The listed phone number is (904) 287-9137.

What is St Johns Eye Associates PA's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is St Johns Eye Associates PA enrolled in Medicare?

Yes. St Johns Eye Associates PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St Johns Eye Associates PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians, all in Optometry, reassign their Medicare billing to St Johns 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. Of these, 1 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does St Johns Eye Associates PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2085317) is associated with this NPI, valid through October 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Johns Eye Associates PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list St Johns 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 St Johns Eye Associates PA was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.