Individual provider Active NPI

Maria Shajida Espat Reich, OD

  • Optometrist
  • Medford, OR
National Provider Identifier
1164415295
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2640AT Issued in OR
Practice address
55 E Stewart Ave Ste B
Medford, OR 97501-7944
Phone
(541) 779-9851
Fax
(541) 779-9853
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2640AT OR Primary

Addresses

Primary practice location

55 E Stewart Ave Ste B
Medford, OR 97501-7944

Mailing address

55 E Stewart Ave
Ste B
Medford, OR 97501-7944
Phone (541) 779-9851

Other identifiers 5

IdentifierTypeStateIssuer
205038OtherCOLE MANAGED VISION
111673OtherPROVIDENCE PREFERRED
410048870OtherRR MEDICARE
150518MedicaidOR
150518OtherOMAP PROVIDER ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20070702000047 OR Practitioner - Optometry 5395730360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 E Stewart Ave
Suite B
Medford, OR 97501-7944
Phone (541) 779-9851

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2640ATORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shajida Espat Reich & Associates PC Optometrist CurrentSince May 1, 2007 Accepting new patients
Jason Bates OD PC Optometrist Past Accepting new patients

Locations

55 E Stewart Ave
Ste B
Medford, OR 97501
Phone (541) 779-9851

1600 N Riverside Ave
Unit 2027
Medford, OR 97501
Phone (541) 779-9851

Organizations & group practices 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1164415295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E STEWART AVE",
            "address_2": "STE B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017944",
            "telephone_number": "541-779-9851",
            "fax_number": "541-779-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E STEWART AVE STE B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017944",
            "telephone_number": "541-779-9851",
            "fax_number": "541-779-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPAT REICH",
        "first_name": "MARIA SHAJIDA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2640AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE MANAGED VISION",
            "identifier": "205038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE PREFERRED",
            "identifier": "111673",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410048870",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150518",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP PROVIDER ID#",
            "identifier": "150518",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.