Serena Shin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV005692-1 Issued in NY

Practice address

7 Miller Rd
Mahopac, NY 10541-2219

Phone

(845) 628-8788

Fax

(845) 628-9581

NPI assigned

Aug 1, 2006

Sex

Female

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 6

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Sparkle Optical CorporationGroup PAC ID 5193081289, 3 clinicians

East Fishkill Eye Care LLCGroup PAC ID 3779903372, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sshin@mahopaceye.direct.eyemdemr.com

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.

• East Fishkill Eye Care LLC

  • Optometrist
  • Hopewell Junction, NY
  • NPI 1265045611
  Medicare reassignment Care Compare group NPD
• Eye Sparkle Optical Corporation

  dba Eye Appeal Optical

  • Optometrist
  • Poughkeepsie, NY
  • NPI 1952835167
  Medicare reassignment Care Compare group NPD
• Mahopac Ophthalmology PC

  • Ophthalmology Physician
  • Mahopac, NY
  • NPI 1184631152
  Medicare reassignment NPD
• East Fishkill Eye Associates Optometrists, P.C.

  • Optometrist
  • Hopewell Junction, NY
  • NPI 1194893776
  NPD
• Eye Appeal Opticians, Inc.

  • Optometrist
  • Lagrangeville, NY
  • NPI 1801941430
  NPD
• Mahopac Eyewear Inc.

  • Durable Medical Equipment & Medical Supplies
  • Mahopac, NY
  • NPI 1437165222
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1669489035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105410959",
            "telephone_number": "845-628-8788",
            "fax_number": "845-628-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MILLER RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412219",
            "telephone_number": "845-628-8788",
            "fax_number": "845-628-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SERENA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005692-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7290443",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2284264",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2803098",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C5916",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE SHIELD",
            "identifier": "C279H1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "393760",
            "identifier": "MVP",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Carolyn Semenetz, RN
• Purvi Shah, DDS
• Gayle Loren Shatzkes
• Dolores E Shields, COTA
• Isra Shilad
• Sara Simone, OTR/L
• Mohan Singh, MD
• Lauren Sleight, COTA/L
• Smile Bright Dental, PLLC
• Philip Lee Smith, DMD

• Optometrist in Mahopac, NY
• Providers in Mahopac, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.