Anjali Shah Patel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5637 Issued in FL

Practice address

13760 Old Saint Augustine Rd Ste 102
Jacksonville, FL 32258-5492

Phone

(904) 379-9068

Fax

(904) 503-0683

NPI assigned

May 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Anjali Shah Other name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Clearwater, FL
  • NPI 1730054594
  NPD
• Myeyedr. Optometry of Florida, LLC

  • Optometrist
  • St Augustine, FL
  • NPI 1568832293
  NPD

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1467018754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13760 OLD SAINT AUGUSTINE RD STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585492",
            "telephone_number": "904-379-9068",
            "fax_number": "904-503-0683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 State Road 312",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320864241",
            "country_code": "US",
            "telephone_number": "904-824-2021",
            "fax_number": "904-824-2039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH PATEL",
        "first_name": "ANJALI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANJALI",
            "last_name": "SHAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shafer Chiropractic Clinic Inc
• Erich Ernest Shafer, D.C.0
• Amanda Lea Shaffer, PMHNP-BC, MSN, RN
• Gayle Denise Shaffer, D.M.D.
• Kara J Shaffer, PA-C
• Andrea Ellen Clark Shah, M.D.
• Antra Jignesh Shah
• Atif A Shah, MD
• Atul Mukutbhai Shah, MD
• Bharat R Shah I, DDS

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.