Individual provider Active NPI

Shreyal Shukla, OD

  • Optometrist
  • Neptune, NJ
National Provider Identifier
1710628979
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00710100 Issued in NJ
Practice address
2200 Route 66 Ste 5
Neptune, NJ 07753-4063
Phone
(732) 775-0013
NPI assigned
Apr 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00710100 NJ Primary

Addresses

Primary practice location

2200 Route 66 Ste 5
Neptune, NJ 07753-4063

Mailing address

2305 Timber Ridge CT
Parlin, NJ 08859-3134
Phone (848) 260-9013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00710100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M Cummins OD PA Optometrist PastSince Apr 10, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 112253@visionworks.emadirect.md

Organizations & group practices 1

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": "1649030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1710628979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 TIMBER RIDGE CT",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088593134",
            "telephone_number": "848-260-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ROUTE 66 STE 5",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534063",
            "telephone_number": "732-775-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "SHREYAL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-04",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00710100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.