Shannon K Stanek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004252 Issued in MI

Practice address

1736 W Michigan Ave
Westwood Mall
Jackson, MI 49202-4005

Phone

(517) 789-7131

Fax

(517) 789-7111

NPI assigned

Dec 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Sky Vision Eye Care PCGroup PAC ID 8820065618, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.03 of 100Reported as group

Quality

85.46

Promoting interoperability

100

Improvement activities

40

Cost

31.32

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: shannon.stanek.p1@direct.grophthalmology.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Sky Vision Eye Care, P.C

  dba Grand Rapids Ophthalmology

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1801977202
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285797324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 S CEDAR ST",
            "address_2": "APT #7",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488542069",
            "telephone_number": "517-896-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 W MICHIGAN AVE",
            "address_2": "WESTWOOD MALL",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492024005",
            "telephone_number": "517-789-7131",
            "fax_number": "517-789-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANEK",
        "first_name": "SHANNON",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Stahl
• Mary J Stahle, DDS
• Kristi Staib, MA LLC
• Pamela Stalter-O'Neil, LMSW
• Carol A Stamm, M.D.
• Lindsay Stanfield, BSW
• Tracy Stanish, DNP, RN, FNP-BC
• Kali Marie Stanton, LLMSW
• Sarah Renee Stark, M.A., CCC-SLP
• Scott David Stark, LPC

• Optometrist in Jackson, MI
• Providers in Jackson, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.