Shani Eliza Rerecich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60291669 Issued in WA

Practice address

1600 E. Jefferson St
Ste #202
Seattle, WA 98122-1737

Phone

(425) 320-2630

NPI assigned

Aug 15, 2012

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

• Shani Eliza Elwood Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Pacific University - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stephan Cassidy OD PSGroup PAC ID 6507195260, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Stephan Cassidy OD PS

  • Optometrist
  • Issaquah, WA
  • NPI 1225195431
  Medicare reassignment Care Compare group NPD
• Grady M. Hughes

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1417097031
  Medicare reassignment NPD

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1619225190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 RIPLEY LANE N",
            "address_2": "#302",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980561576",
            "telephone_number": "425-273-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E. JEFFERSON ST",
            "address_2": "STE #202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981221737",
            "telephone_number": "425-320-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RERECICH",
        "first_name": "SHANI",
        "middle_name": "ELIZA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60291669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANI",
            "last_name": "ELWOOD",
            "middle_name": "ELIZA",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel P Replogle, LICSW
• Veronika Repova
• Pavle Repovic, MD, PHD
• Emily Repp
• Lisa L Reppert, ARNP
• Rescare Inc.
• Rescare Washington, Inc.
• Devony Resch, DC
• Kyla Resch, PRSS
• Reschenthaler and Reschenthaler, DMD, PLLC

• Optometrist in Seattle, WA
• Providers in Seattle, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.