Individual provider Active NPI

Julianne Rene Shelton, OD

  • Optometrist
  • Pulaski, NY
National Provider Identifier
1467930586
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008831 Issued in NY
Practice address
3333 Maple Ave Ste 2
Pulaski, NY 13142-2548
Phone
(315) 298-6966
NPI assigned
Jul 31, 2018
Last updated
Jul 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008831 NY Primary

Addresses

Primary practice location

3333 Maple Ave Ste 2
Pulaski, NY 13142-2548

Mailing address

20 Normandy Cir
Central Square, NY 13036-2431
Phone (315) 380-2110

Other identifiers 1

IdentifierTypeStateIssuer
TUV008831OtherNYOPTOMETRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181010001503 NY Practitioner - Optometry 0042562688 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David J. Braun, O.D., P.C.Group PAC ID 9032241963, 3 clinicians
Carolyn a Cutre OD PLLCGroup PAC ID 7315918661, 2 clinicians

Practice addresses (Care Compare)

120 Julian PL
Syracuse, NY 13210-3460

53 -59 Public SQ
Suite 100
Watertown, NY 13601-2174
Phone (315) 214-5858

8390 Elta Dr
Cicero, NY 13039-8905
Phone (315) 752-0555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008831NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sightrite Inc Optometrist CurrentSince Aug 4, 2019 Accepting new patients
David J Dexter OD PC Optometrist CurrentSince Nov 11, 2018 Accepting new patients
Carolyn a Cutre, O.D. PLLC Optometrist CurrentSince Aug 28, 2019 Accepting new patients
David J. Dexter, O.D., P.C. Optometrist Past Accepting new patients

Locations

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

8390 Elta Dr
Cicero, NY 13039
Phone (315) 752-0555

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

120 E 1st St
Ste 1
Oswego, NY 13126
Phone (315) 343-2020

3333 Maple Ave
Ste 2
Pulaski, NY 13142
Phone (315) 298-6966

134 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 321-3850

Interoperability endpoints

  • FHIR API: https://davidjdexterodpc.ef.prod.fhir.ema-api.com/fhir/r4/
  • FHIR API: https://davidjdexterodpcwatertown.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 5

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1467930586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NORMANDY CIR",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362431",
            "telephone_number": "315-380-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 MAPLE AVE STE 2",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131422548",
            "telephone_number": "315-298-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JULIANNE",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "TUV008831",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, NY

Sources for this page

Verify at the official NPI Registry.