Individual provider Active NPI

Trenton Elliot Shuke

  • Optometrist
  • Christiana, PA
National Provider Identifier
1003657602
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004152 Issued in PA
Practice address
PO Box 75
Christiana, PA 17509-0075
Phone
(610) 593-6670
Fax
(610) 593-2327
NPI assigned
Jun 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004152 PA Primary

Addresses

Primary practice location

PO Box 75
Christiana, PA 17509-0075

Mailing address

PO Box 75
Christiana, PA 17509-0075
Phone (610) 593-6670

Other practice location 1

PO Box 699
Ephrata, PA 17522-0699
Phone (717) 738-2488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240706000100 PA Practitioner - Optometry 3779027396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ephrata Family Eye Care LLPGroup PAC ID 6800869918, 3 clinicians

Practice addresses (Care Compare)

101 E Main St
Ephrata, PA 17522-2710
Phone (717) 738-2488

316 Newport Ave
Christiana, PA 17509-1312
Phone (610) 593-6670

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Family Eye Care LLP Optometrist CurrentSince May 30, 2024 Accepting new patients
Christiana Eyecare LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Mervin W Stoltzfus OD Optometrist PastSince Jun 9, 2024 Accepting new patients

Locations

316 Newport Ave
Christiana, PA 17509
Phone (610) 593-6670

101 E Main St
Ephrata, PA 17522
Phone (717) 733-7467

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1003657602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75",
            "city": "CHRISTIANA",
            "state": "PA",
            "postal_code": "175090075",
            "telephone_number": "610-593-6670",
            "fax_number": "610-593-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 75",
            "city": "CHRISTIANA",
            "state": "PA",
            "postal_code": "175090075",
            "telephone_number": "610-593-6670",
            "fax_number": "610-593-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 699",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175220699",
            "country_code": "US",
            "telephone_number": "717-738-2488",
            "fax_number": "717-721-9088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUKE",
        "first_name": "TRENTON",
        "middle_name": "ELLIOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiana, PA

Sources for this page

Verify at the official NPI Registry.