Organization Active NPI

Shade Eyecare, LLC

  • Optometrist
  • Pottstown, PA
National Provider Identifier
1699941179
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000169 Issued in PA
Legal business name
SHADE EYECARE, LLC
Practice address
142 Shoemaker Rd
Pottstown, PA 19464-6430
Phone
(610) 326-1106
Fax
(610) 326-1108
NPI assigned
May 5, 2008
Last updated
Aug 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Authorized official

Name
Dr. Michele Shade, O.D.
Title
Owner
Phone
(610) 326-1106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000169 PA Primary
Eyewear Supplier 332H00000X OEG000169 PA

Addresses

Primary practice location

142 Shoemaker Rd
Pottstown, PA 19464-6430

Mailing address

142 Shoemaker Rd
Pottstown, PA 19464-6430
Phone (610) 326-1106

Other names 1

  • Dr. Michele Y. Shade, Optometrist Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090610000595 PA Part B Supplier - Clinic/Group Practice 7214087360 Receives reassigned benefits from 2 practitioners
Practice locations: Pottstown, PA
O20100930080579 PA DME Supplier - Physician - OptometristDME Supplier - Optician 7214087360 Practice locations: Pottstown, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1699941179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SHOEMAKER RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646430",
            "telephone_number": "610-326-1106",
            "fax_number": "610-326-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SHOEMAKER RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646430",
            "telephone_number": "610-326-1106",
            "fax_number": "610-326-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADE EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "SHADE",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-326-1106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000169",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PA",
            "license": "OEG000169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Michele Y. Shade, Optometrist",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.