Gary Dean Shute, O.D., F.A.A.O.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8857T Issued in CA

Practice address

3945 1St Ave
San Diego, CA 92103-3015

Phone

(619) 295-4194

Fax

(619) 295-4930

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael a. Kling OD, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1760550768
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1609944610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033015",
            "telephone_number": "619-295-4194",
            "fax_number": "619-295-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033015",
            "telephone_number": "619-295-4194",
            "fax_number": "619-295-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "GARY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "O.D., F.A.A.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8857T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0088570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Rose Shurer, FNP
• Joseph Shurman, M.D.
• Jesse Daniel Shurter, MD
• Kira Shurtz, DPT
• Sharon Shusterman
• Brett B Shuttleworth
• Alfred F Shwayhat, D.O.
• Nicole Diane Shy, RN, RDH
• Lyudmyla Shymkiv
• Moumita Si Pallachulla

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.