Individual provider Active NPI

Shelby Rockwell, OD

  • Optometrist
  • Buffalo, NY
National Provider Identifier
1548746720
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ORT008833-01 Issued in NY
Practice address
1176 Main St
Buffalo, NY 14209-2102
Phone
(716) 881-7900
Fax
(716) 881-4349
NPI assigned
Jul 11, 2018
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ORT008833-01 NY Primary

Addresses

Primary practice location

1176 Main St
Buffalo, NY 14209-2102

Mailing address

1176 Main St
Buffalo, NY 14209-2102
Phone (716) 881-7900

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherNYMEDICARE

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
I20180726001919 NY Practitioner - Optometry 4880941566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008833-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew J. Siedlecki, M.D., PC CurrentSince Jan 1, 2022 Accepting new patients
Sunrise Surgery Center LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

3349 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 508-0995

170 Maple Rd
Williamsville, NY 14221
Phone (716) 634-4050

Organizations & group practices 2

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1548746720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092102",
            "telephone_number": "716-881-7900",
            "fax_number": "716-881-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092102",
            "telephone_number": "716-881-7900",
            "fax_number": "716-881-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "SHELBY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "ORT008833-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.