Individual provider Active NPI

Glenn Stephen Shear, M.D.

  • Ophthalmology Physician
  • Riverdale, GA
National Provider Identifier
1285644542
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
019998 Issued in GA
Practice address
33 Upper Riverdale Rd SW
Suite 114
Riverdale, GA 30274-2626
Phone
(770) 991-1624
Fax
(770) 991-9206
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 019998 GA Primary

Addresses

Primary practice location

33 Upper Riverdale Rd SW
Suite 114
Riverdale, GA 30274-2626

Mailing address

33 Upper Riverdale Rd SW
Suite 114
Riverdale, GA 30274-2626
Phone (770) 991-1624

Other identifiers 2

IdentifierTypeStateIssuer
000189153AMedicaidGA
180018544OtherGAPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000597 GA Practitioner - Ophthalmology 8022131192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn S Shear MDPC Ophthalmology CurrentSince Oct 11, 1978 Accepting new patients
Sheer Vision Center LLC Past Accepting new patients

Locations

33 Upper Riverdale Rd SW
Ste 114
Riverdale, GA 30274
Phone (770) 991-1624

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1285644542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 114",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-991-1624",
            "fax_number": "770-991-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 114",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-991-1624",
            "fax_number": "770-991-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAR",
        "first_name": "GLENN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "019998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000189153A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "180018544",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.