Organization Active NPI

Shirley Eye Care LLC

  • Optometrist
  • Indiana, PA
National Provider Identifier
1043610967
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002899 Issued in PA
Legal business name
SHIRLEY EYE CARE LLC
Practice address
241 Rustic Lodge Rd
Indiana, PA 15701-3472
Phone
(724) 463-8882
Fax
(724) 465-8550
NPI assigned
Aug 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Dr. Matthew Paul Shirley, O.D.NPI 1568877298
Title
Doctor of Optometry
Phone
(724) 859-3378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG002899 PA Primary

Addresses

Primary practice location

241 Rustic Lodge Rd
Indiana, PA 15701-3472

Mailing address

241 Rustic Lodge Rd
Indiana, PA 15701-3472
Phone (724) 463-8882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150107002279 PA Part B Supplier - Clinic/Group Practice 7214250729 Receives reassigned benefits from 3 practitioners
Practice locations: Indiana, PA

National Provider Directory

National Provider Directory

Locations

241 Rustic Lodge Rd
Indiana, PA 15701
Phone (724) 463-8882

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1043610967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 RUSTIC LODGE RD",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013472",
            "telephone_number": "724-463-8882",
            "fax_number": "724-465-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 RUSTIC LODGE RD",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013472",
            "telephone_number": "724-463-8882",
            "fax_number": "724-465-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "724-859-3378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.