Individual provider Active NPI

Leigh Sha R Chervenka, OD

  • Optometrist
  • Nashua, NH
National Provider Identifier
1093931271
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
817 Issued in NH
Practice address
163 Amherst St Ste C
Nashua, NH 03064-1367
Phone
(603) 320-8880
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 817 NH Primary
Optometrist 152W00000X 304T WY
Optometrist 152W00000X 4229TP MA
Optometrist 152W00000X 5106T TX
Optometrist 152W00000X 561 SD

Addresses

Primary practice location

163 Amherst St Ste C
Nashua, NH 03064-1367

Mailing address

78 North Pepperell Road
Hollis, NH 82009
Phone (603) 465-3530

Other practice location 1

175 Littleton Road
Westford, MA 01886
Phone (978) 692-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031104000064 MA Practitioner - Optometry 4981516408 Practice locations: Westford, MA
I20180523001639 NH Practitioner - Optometry 4981516408 Practice locations: Nashua, NH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

163 Amherst St
Nashua, NH 03064-1396
Phone (603) 320-8880

175 Littleton Rd
Westford, MA 01886-3196
Phone (978) 692-7575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4229TPMAMDOptometrist
817NHMDOptometrist
561SDMDOptometrist
5106TTXMDOptometrist
304TWYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1093931271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 NORTH PEPPERELL ROAD",
            "city": "HOLLIS",
            "state": "NH",
            "postal_code": "82009",
            "telephone_number": "603-465-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 AMHERST ST STE C",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030641367",
            "telephone_number": "603-320-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Littleton Road",
            "address_purpose": "LOCATION",
            "city": "Westford",
            "state": "MA",
            "postal_code": "01886",
            "country_code": "US",
            "telephone_number": "978-692-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERVENKA",
        "first_name": "LEIGH",
        "middle_name": "SHA R",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-09-21",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "817",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "304T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4229TP",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5106T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.