Individual provider Active NPI

Shelly Anastasio, O.D.

  • Optometrist
  • Covington, LA
National Provider Identifier
1407826464
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1355-489T Issued in LA
Practice address
1431 Ochsner Blvd
Suite a
Covington, LA 70433-8110
Phone
(985) 875-7898
Fax
(985) 875-9844
NPI assigned
Jan 24, 2006
Last updated
Apr 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1355-489T LA Primary

Addresses

Primary practice location

1431 Ochsner Blvd
Suite a
Covington, LA 70433-8110

Mailing address

1431 Ochsner Blvd
Suite a
Covington, LA 70433-8110
Phone (985) 875-7898

Other identifiers 1

IdentifierTypeStateIssuer
1150461MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20040929000067 LA Practitioner - Optometry 3375512189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Family Eyecare, LLCGroup PAC ID 7113074717, 5 clinicians

Practice addresses (Care Compare)

1431 Ochsner Blvd
Suite a
Covington, LA 70433-8246
Phone (985) 875-7898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1355-489TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Family Eyecare, LLC Optometrist CurrentSince May 1, 2009 Accepting new patients

Locations

107 Terra Bella Blvd
Covington, LA 70433
Phone (985) 875-7898

1431 Ochsner Blvd
Ste A
Covington, LA 70433
Phone (985) 302-5225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1407826464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 OCHSNER BLVD",
            "address_2": "SUITE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338110",
            "telephone_number": "985-875-7898",
            "fax_number": "985-875-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 OCHSNER BLVD",
            "address_2": "SUITE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338110",
            "telephone_number": "985-875-7898",
            "fax_number": "985-875-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANASTASIO",
        "first_name": "SHELLY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1355-489T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1150461",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.