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ST JOHNS EYE ASSOCIATES AT NOCATEE
NPI 1629326343
Optometrist in Ponte Vedra, FL

Active since August 28, 2012CLIA 10D2099304 · Waiver
200 NOCATEE VILLAGE DRIVE, PONTE VEDRA, FL 32081(904) 825-4525(904) 825-4520 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About St Johns Eye Associates At Nocatee NPPES

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

ST JOHNS EYE ASSOCIATES AT NOCATEE (NPI 1629326343) is a healthcare organization registered as an optometrist in Ponte Vedra, Florida and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through July 23, 2027 and lists Donna Marie Backs, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1629326343
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameST JOHNS EYE ASSOCIATES AT NOCATEE
Location Address200 NOCATEE VILLAGE DRIVEPonte Vedra, FL 32081
Mailing Address100 Marketside AvenuePonte Vedra, FL 32081-0582 · (904) 825-4525 · Fax (904) 825-4520
Phone(904) 825-4525
Fax(904) 825-4520
Organization SubpartNo
Authorized OfficialDonna Marie BacksCredentialing · (805) 433-2901
Enumeration DateAugust 28, 2012
Last NPPES UpdateAugust 19, 2022
NPPES CertifiedJune 7, 2022
✔ NPI 1629326343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in FL · OPC 3241
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.
200 NOCATEE VILLAGE DRIVE, Ponte Vedra, FL 32081
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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), Molina Healthcare.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 At Nocatee 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 At Nocatee, 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)

Ngan Kim Lam
Optometry
NPI 1407423247
200 NOCATEE VILLAGE DR
Ponte Vedra, FL 32081
(904) 825-4525
✔ 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 Medicare8.0 mi
Sharokh Kapadia, OD
Optometry
NPI 1942299847
161-3 HAMPTON POINT DRIVE
St. Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Shawna Moinipour, O.D.
Optometry
NPI 1447091657
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Chelsea Nissinoff, OD
Optometry
NPI 1720715634
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Jhaleil Phillips, OD
Optometry
NPI 1972111847
161 HAMPTON POINT DR STE 3
Saint Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Samantha Price
Optometry
NPI 1538511993
161 HAMPTON POINT DR STE 3
Saint Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Dillon Smith, OD
Optometry
NPI 1245722917
161 HAMPTON POINT DR STE 3
St Augustine, FL 32092
(904) 287-9137
✔ PECOS✔ Accepts Medicare8.0 mi
Gina Kubesh, OD
Optometry
NPI 1538042767
150 VILLAGE COMMONS DR STE 102
St Augustine, FL 32092
(904) 530-9802
✔ PECOS✔ Accepts Medicare11 mi
Dea Opari
Optometry
NPI 1245075001
11406 SAN JOSE BLVD STE 1
Jacksonville, FL 32223
(904) 578-1981
✔ PECOS13 mi
Morgan Kickliter
Optometry
NPI 1487146635
10400 SAN JOSE BLVD STE 6
Jacksonville, FL 32257
(904) 880-1818
✔ PECOS✔ Accepts Medicare14 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 10D2099304

St Johns Eye Associates PA · Ponte Vedra, FL
Active · expires Jul 23, 2027
CLIA Number10D2099304
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorSharokh Kapadia
Laboratory Phone(904) 825-4525
Laboratory LocationSt Johns Eye Associates PA200 Nocatee Village Drive, Ponte Vedra, FL 32081
CLIA data matches this NPI record on: Address 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 At Nocatee's NPI number?

The NPI number for St Johns Eye Associates At Nocatee is 1629326343. It was assigned to this organization in the NPPES registry on August 28, 2012.

Where is St Johns Eye Associates At Nocatee located?

St Johns Eye Associates At Nocatee is located at 200 Nocatee Village Drive, Ponte Vedra, FL 32081. The listed phone number is (904) 825-4525.

What is St Johns Eye Associates At Nocatee's specialty?

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

Is St Johns Eye Associates At Nocatee enrolled in Medicare?

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

How many clinicians bill Medicare through St Johns Eye Associates At Nocatee?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians, all in Optometry, reassign their Medicare billing to St Johns Eye Associates At Nocatee. 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 At Nocatee hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2099304) is associated with this NPI, valid through July 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Johns Eye Associates At Nocatee accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list St Johns Eye Associates At Nocatee 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 At Nocatee was last updated on August 19, 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.