Individual provider Active NPI

Todd Alan Shuba, OD

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1275599623
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001557 Issued in PA
Practice address
120 5TH Ave Place
#M107
Pittsburgh, PA 15222
Phone
(412) 471-1306
Fax
(412) 471-1896
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X FL2889 FL
Optometrist 152W00000X OEG001557 PA Primary

Addresses

Primary practice location

120 5TH Ave Place
#M107
Pittsburgh, PA 15222

Mailing address

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 445-7465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050518000115 PA Practitioner - Optometry 4688633050 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL2889FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Jul 7, 2024 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jul 7, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Jul 7, 2024 Accepting new patients
Visionworks, Inc CurrentSince Jul 7, 2024 Accepting new patients

Locations

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

854 Plaza Blvd
Lancaster, PA 17601
Phone (717) 295-3111

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

120 5th Ave
#M107
Pittsburgh, PA 15222
Phone (412) 471-1306

Organizations & group practices 4

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275599623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13224",
            "telephone_number": "315-445-7465",
            "fax_number": "315-445-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 5TH AVE PLACE",
            "address_2": "#M107",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15222",
            "telephone_number": "412-471-1306",
            "fax_number": "412-471-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBA",
        "first_name": "TODD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL2889",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.