Individual provider Active NPI

Shaleen Ragha, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1013365642
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3281 Issued in TN
Practice address
1030 Jefferson Ave
Memphis, TN 38104-2127
Phone
(901) 523-8990
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3281 TN Primary

Addresses

Primary practice location

1030 Jefferson Ave
Memphis, TN 38104-2127

Mailing address

510 Park Creek Way
Alpharetta, GA 30022-3491
Phone (770) 380-5985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20170913004029 TN Practitioner - Optometry 9931472925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3281TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Aug 1, 2017 Accepting new patients

Locations

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

1350 Concourse Ave
Ste 264
Memphis, TN 38104
Phone (901) 252-3670

Networks

  • KY PPO
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • KY PPO C-SNP
  • MS PPO C-SNP
  • TN PPO
  • MS PPO D-SNP
  • MS PPO

Organizations & group practices 1

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1013365642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PARK CREEK WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300223491",
            "telephone_number": "770-380-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHA",
        "first_name": "SHALEEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.