Active NPI
Shanda Pearl Ross, O.D.
- Optometrist
- Eatontown, NJ
National Provider Identifier
1487897260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00617500
- Practice address
- 10 Industrial Way E Ste 2
Eatontown, NJ 07724-3333 - Phone
- (812) 677-1186
- NPI assigned
- Apr 9, 2009
- Last updated
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27OA00617500 | NJ | Primary |
Addresses
Primary practice location
10 Industrial Way E Ste 2
Eatontown, NJ 07724-3333
Mailing address
10 Industrial Way E Ste 2
Eatontown, NJ 07724-3333
Phone (812) 677-1186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 Walnut St
Evansville, IN 47713-1963
Phone (812) 421-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Optometry Group, P.a. | Optometrist | Past | Accepting new patients |
| Northwest Optometry Group, P.a. | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Ophthalmology Physician
- Evansville, IN
- NPI 1407809031
-
- Optometrist
- Sparta, NJ
- NPI 1801853254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1487897260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 INDUSTRIAL WAY E STE 2",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077243333",
"telephone_number": "812-677-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 INDUSTRIAL WAY E STE 2",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077243333",
"telephone_number": "812-677-1186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "SHANDA",
"middle_name": "PEARL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-09",
"last_updated": "2020-10-28",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00617500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatontown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.