Individual provider Active NPI

Shaista Vally

  • Optometrist
  • Farmington, NM
National Provider Identifier
1619343712
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1997DT Issued in KY
Practice address
3450 E Main St
Farmington, NM 87402-5327
Phone
(505) 325-7070
Fax
(505) 325-5812
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 1997DT KY Primary

Addresses

Primary practice location

3450 E Main St
Farmington, NM 87402-5327

Mailing address

740 South Limestone
E300 Kentucky Clinic
Lexington, KY 40536

Other practice location 1

1300 Oretha Castle Haley Blvd Ste B
New Orleans, LA 70113-1289
Phone (504) 899-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190909000188 LA Practitioner - Optometry 3173830734 Reassigns benefits to 3 organizations
I20260528002211 NM Practitioner - Optometry 3173830734

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skyview Eyecare IncGroup PAC ID 1254405426, 4 clinicians

Practice addresses (Care Compare)

3450 E Main St
Farmington, NM 87402-5327
Phone (505) 325-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1997DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marillac Community Health Centers CurrentSince Jun 19, 2025 Accepting new patients
Ascension Depaul Services CurrentSince Aug 1, 2024 Accepting new patients
Marillac Community Health Centers CurrentSince Jun 19, 2025 Accepting new patients
Vision Optique Inc Optometrist CurrentSince Aug 6, 2019 Accepting new patients
Marillac Community Health Centers Current Accepting new patients
Ascension Depaul Services Current Accepting new patients
Daughters of Charity Services of New Orleans CurrentSince Aug 1, 2024 Accepting new patients
Marillac Community Health Centers Past Accepting new patients
Ascension Depaul Services Past Accepting new patients

Locations

2997 Highway 190
Mandeville, LA 70471
Phone (985) 727-9948

3242 Severn Ave
Metairie, LA 70002
Phone (504) 455-0764

3201 S Carrollton Ave
New Orleans, LA 70118
Phone (504) 207-3019

2801 General Degaulle Dr
Ste A
New Orleans, LA 70114
Phone (504) 362-8930

2801 General Degaulle Dr
New Orleans, LA 70114
Phone (504) 362-8930

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1619343712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 SOUTH LIMESTONE",
            "address_2": "E300 KENTUCKY CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E MAIN ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025327",
            "telephone_number": "505-325-7070",
            "fax_number": "505-325-5812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Oretha Castle Haley Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701131289",
            "country_code": "US",
            "telephone_number": "504-899-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLY",
        "first_name": "SHAISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1997DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.