MS. CHARLOTTE FAE (OD) – Optometrist, NPI 1891587481

MS. CHARLOTTE FAE (OD) is a healthcare provider. based in Port orange, Florida. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPC6724 (FL). The NPI Number for MS. CHARLOTTE FAE (OD) is 1891587481

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MS. CHARLOTTE FAE (OD)
NPI
1891587481
Phone
(386) 767-0053
Address
790 Dunlawton Ave Ste A
Enumeration Date
20 May 2025
Last Update Date
11 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3866724244
Graduation Year
2025 (1 year ago)
PAC ID
0840700555
Group Practice PAC ID
2163470436
Professional Enrollment ID
I20250611002511
Address ID
FL321743114OR345XXBLVD404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

2,055 OPTOMETRY in FL

Provider Addresses for MS. CHARLOTTE FAE (OD)

  • 790 Dunlawton Ave Ste A

    Port Orange, FL 321274222

    Phone: (386) 767-0053

    Fax: (386) 767-3490

    Type: Location

  • 345 CLYDE MORRIS BLVD STE 330

    ORMOND BEACH, FL 321743114

    Phone: (386) 672-4244

    Fax: (386) 672-0603

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250611002511IOptometryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163470436View full group profile
NameSpecialtyState
O P H T H A L M O L O G YFL
O P H T H A L M O L O G YFL
O P H T H A L M O L O G YFL
O P H T H A L M O L O G YAA
-FL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P H T H A L M O L O G YFL
-FL

Reviews

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Frequently asked questions

Where can patients find MS. CHARLOTTE FAE (OD)'s NPI?
You can confirm MS. CHARLOTTE FAE (OD) with NPI 1891587481; it appears in the national provider directory.
Is MS. CHARLOTTE FAE (OD)'s NPI currently valid?
The extract we use shows MS. CHARLOTTE FAE (OD) as active.
What kind of provider is MS. CHARLOTTE FAE (OD)?
The page reflects Optometrist for MS. CHARLOTTE FAE (OD). Clinical services aligned with this taxonomy classification.
What location shows for MS. CHARLOTTE FAE (OD)?
We surface Port Orange, Florida for MS. CHARLOTTE FAE (OD) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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