Shane Ryan Sanders, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002281 Issued in AZ

Practice address

980 Willow Creek Rd Ste 202
Prescott, AZ 86301-1616

Phone

(928) 778-3937

Fax

(928) 778-3939

NPI assigned

Jul 13, 2018

Last updated

May 19, 2026By the provider in NPPES

Sex

Male

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 AZ

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matthew R Sullivan OD PCGroup PAC ID 0749275378, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Merit-based Incentive Payment System (MIPS)

Final score

88.66 of 100Reported as group

Quality

84.9

Promoting interoperability

100

Improvement activities

40

Cost

77.31

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shane.sanders@direct.avp.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.

• Matthew R Sullivan OD

  dba Premier Eye Center

  • Optometrist
  • Prescott, AZ
  • NPI 1285813360
  Medicare reassignment Care Compare group NPD
• Barnet Dulaney Perkins Eye Center, PC

  dba American Vision Partners

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1376574707
  Medicare reassignment NPD
• Southwestern Eye Center LTD

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1023063187
  Medicare reassignment NPD
• Barnet Dulaney Perkins Eye Center, PC

  dba American Vision Partners

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1043910078
  NPD
• Barnet Dulaney Perkins Eye Center, PC

  dba American Vision Partners

  • Ophthalmology Physician
  • Flagstaff, AZ
  • NPI 1689619272
  NPD
• Southwestern Eye Center LTD

  • Optometrist
  • Scottsdale, AZ
  • NPI 1851624647
  NPD
• Southwestern Eye Center, LTD

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1558102608

  Optometrist

  NPD
• Barnet Dulaney Perkins Eye Center, PC

  dba American Vision Partners

  • Ophthalmology Physician
  • Cottonwood, AZ
  • NPI 1013952522
  NPD (past)
• Barnet Dulaney Perkins Eye Center, PC

  dba American Vision Partners

  • Ophthalmology Physician
  • Safford, AZ
  • NPI 1649202771
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yavapai Community Hospital Association

  dba Yavapai Regional Medical Center

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1396221230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 WILLOW CREEK RD STE 202",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011616",
            "telephone_number": "928-778-3937",
            "fax_number": "928-778-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 WILLOW CREEK RD STE 202",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011616",
            "telephone_number": "928-778-3937",
            "fax_number": "928-778-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SHANE",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-13",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oryan Salberg, D.C.
• John David Sandeen, M.D.
• Mary E Sandeen, CPNP
• Sander Physical Therapy LTD.
• Eric John Sanders, KINESIOTHERAPIST
• Timothy Patrick Sanderson, MS, LASAC
• Lance Sandleben, RPH
• Sandretto Hills Nursing Center 2 (Mountain View Manor)
• Cody Sandri
• Alexander Saniuk, PHARMD

• Optometrist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.