Les Alan Shipley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5775T Issued in CA

Practice address

1430 Guerneville Rd
Ste 3
Santa Rosa, CA 95403

Phone

(707) 525-9920

Fax

(707) 525-0844

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 2

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

• Margot Shipley, O.D.

  • Optometrist
  • Santa Rosa, CA
  • NPI 1437467859
  Medicare reassignment
• Nicole Janell Wood, OD

  • Optometrist
  • Santa Rosa, CA
  • NPI 1194976936
  Medicare reassignment

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.

• Dr. Shipley & Associates

  • Optometrist
  • Santa Rosa, CA
  • NPI 1053781427
  NPD Authorized official

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1225011653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 GUERNEVILLE RD",
            "address_2": "STE 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-525-9920",
            "fax_number": "707-525-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 GUERNEVILLE RD",
            "address_2": "STE 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-525-9920",
            "fax_number": "707-525-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "LES",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5775T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0057750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell P Shields
• Sharon Shields
• Julie Shimko, RD
• Rose Shine
• Janice Lillian Shipley, FNP
• Margot Shipley, O.D.
• Jennifer Tom Shipp, FNP
• Kim Shippey, LCSW
• Sylvia Shirikian, PSY.D.
• Michael Shawn Shirley

• Optometrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.