Individual provider Active NPI

Chad Aaron Shultz, O.D.

  • Optometrist
  • Poland, OH
National Provider Identifier
1003909094
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT005575 Issued in OH
Practice address
1075 W Western Reserve Rd
Poland, OH 44514-3541
Phone
(330) 746-7691
Fax
(330) 743-8368
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT005575 OH Primary

Addresses

Primary practice location

1075 W Western Reserve Rd
Poland, OH 44514-3541

Mailing address

10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 746-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20121015000166 OH Practitioner - Optometry 2163672858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates, IncGroup PAC ID 0042350118, 14 clinicians

Practice addresses (Care Compare)

4060 N River Rd NE
Warren, OH 44484-1039
Phone (330) 884-6584

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
93.28
Promoting interoperability
100
Improvement activities
40
Cost
48.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT005575OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates, Inc Optometrist Current Accepting new patients
Eye Care Associates, Inc Optometrist CurrentSince Nov 5, 2012 Accepting new patients
Eye Care Associates, Inc Optometrist CurrentSince Nov 5, 2012 Accepting new patients

Locations

15655 State Route 170
Ste O
East Liverpool, OH 43920
Phone (330) 746-7691

1075 W Western Reserve Rd
Poland, OH 44514
Phone (330) 746-7691

4060 N River Rd NE
Warren, OH 44484
Phone (330) 746-7691

10 Dutton Dr
Youngstown, OH 44502
Phone (330) 746-7691

2670 S Raccoon Rd
Ste 1
Youngstown, OH 44515
Phone (330) 746-7691

Networks

  • OH PPO
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

Interoperability endpoints

  • Direct secure messaging: chad.shultz.p1@direct.eyecare.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: cshultz@ecaoh.intellechartdirect.net

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1003909094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DUTTON DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445021818",
            "telephone_number": "330-746-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143541",
            "telephone_number": "330-746-7691",
            "fax_number": "330-743-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "CHAD",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT005575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.