NPIMap

Individual provider Active NPI

Shane D. Hartman, O.D.

  • Optometrist
  • Sioux Falls, SD
National Provider Identifier
1699818013
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
586 Issued in SD
Practice address
1621 S Minnesota Ave
Sioux Falls, SD 57105-1743
Phone
(605) 328-9200
Fax
(605) 328-9201
NPI assigned
Feb 15, 2007
Last updated
Dec 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 586 SD Primary

Addresses

Primary practice location

1621 S Minnesota Ave
Sioux Falls, SD 57105-1743

Mailing address

2310 S Marion Rd
Ste 140
Sioux Falls, SD 57106-1144
Phone (605) 361-2058

Other identifiers 2

IdentifierTypeStateIssuer
9201352MedicaidSD
42581OtherSDSPECTERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000835 SD Practitioner - Optometry 0345366100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians
Sanford ClinicGroup PAC ID 0244143824, 268 clinicians

Practice addresses (Care Compare)

1621 S Minnesota Ave
Sioux Falls, SD 57105-1743
Phone (605) 328-9200

2310 S Marion Rd
Suite 140
Sioux Falls, SD 57106-1144
Phone (605) 328-6690

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-5635

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
75.87
Promoting interoperability
100
Improvement activities
40
Cost
68.53

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
586SDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Jan 13, 2020 Accepting new patients
Sanford Clinic CurrentSince Jan 13, 2020 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Jan 13, 2020 Accepting new patients
Sanford Clinic Past Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1621 S Minnesota Ave
Sioux Falls, SD 57105
Phone (605) 328-4700

2310 S Marion Rd
Ste 140
Sioux Falls, SD 57106
Phone (605) 328-6690

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1699818013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 S MARION RD",
            "address_2": "STE 140",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571061144",
            "telephone_number": "605-361-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051743",
            "telephone_number": "605-328-9200",
            "fax_number": "605-328-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "SHANE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201352",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "42581",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.