Sabrina M Shultz, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009802 Issued in IL

Practice address

18 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502

Phone

(618) 656-7774

Fax

(618) 656-0536

NPI assigned

Feb 5, 2007

Last updated

May 20, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

University of Missouri St Louis - School of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J a K Enterprises IncGroup PAC ID 3173519014, 24 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.84 of 100Reported as group

Quality

92.01

Improvement activities

40

Cost

76.78

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 33)

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.

• J a K Enterprises Inc

  dba Bard Optical

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923

  Optometrist

  Medicare reassignment Care Compare group NPD
• JFJ Eyecare, LTD

  dba Quantum Vision Centers

  • Optometrist
  • Swansea, IL
  • NPI 1376586685
  Medicare reassignment NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Ballwin, MO
  • NPI 1548635758

  IL

  Medicare reassignment NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Centralia, IL
  • NPI 1730373648
  NPD
• J a K Enterprises Inc

  dba Bard Optical

  • Durable Medical Equipment & Medical Supplies
  • Litchfield, IL
  • NPI 1205663499

  Optometrist

  NPD
• JFJ Eyecare LTD

  dba Quantum Vision Centers

  • Optometrist
  • Swansea, IL
  • NPI 1295778587
  NPD
• Pec Brighton PLLC

  dba Performance Eyecare

  • Optometrist
  • Brighton, IL
  • NPI 1689490070
  NPD
• Family Eye Care Association, P.C.

  • Optometrist
  • Litchfield, IL
  • NPI 1790865368
  NPD (past)
• Illinois Retina Surgery LTD

  • Ophthalmic Technician/Technologist
  • Swansea, IL
  • NPI 1255374559
  NPD (past)
• J a K Enterprises Inc

  dba Bard Optical

  • Durable Medical Equipment & Medical Supplies
  • Galesburg, IL
  • NPI 1033163282

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  dba Bard Optical

  • Durable Medical Equipment & Medical Supplies
  • Canton, IL
  • NPI 1124072269

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  dba Bard Optical

  • Durable Medical Equipment & Medical Supplies
  • Pekin, IL
  • NPI 1164476354

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1316086580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047015",
            "telephone_number": "217-698-3030",
            "fax_number": "217-698-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 GINGER CREEK PKWY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502",
            "telephone_number": "618-656-7774",
            "fax_number": "618-656-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 Corporate Ctr",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620404195",
            "country_code": "US",
            "telephone_number": "618-931-6980",
            "fax_number": "618-931-2470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 Dadrian Prof Park",
            "address_purpose": "LOCATION",
            "city": "Godfrey",
            "state": "IL",
            "postal_code": "620351685",
            "country_code": "US",
            "telephone_number": "618-433-5005",
            "fax_number": "618-467-1053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 W Iles Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627047015",
            "country_code": "US",
            "telephone_number": "217-698-3030 x105",
            "fax_number": "217-698-4728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Maryville Professional Center",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "62062",
            "country_code": "US",
            "telephone_number": "618-288-7266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "SABRINA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009802",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Ann Schwarz
• Tieg Bryant Selberg, DDS
• Artiola Roci Shaholli
• Shawnee Hills Oral & Maxillofacial Surgery (Metro OMS)
• Ashley Shellenberger
• Dustin Jay Simpson, DMD
• Kendra Elizabeth Sloan
• Bartholomew Smarr
• Kate Smith
• Kayla Smith

• Optometrist in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.