Jerry R Shields, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD00039681 Issued in WA

Practice address

1703 S. Meridian
Suite 101
Puyallup, WA 98371

Phone

(253) 848-3000

Fax

(253) 840-6514

NPI assigned

Aug 12, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Medical College of Georgia School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grady M. HughesGroup PAC ID 8426946823, 2 clinicians

Sharpevision PLLCGroup PAC ID 5496917791, 11 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshields@sharpevision.emadirect.md
• Direct secure messaging: j.shields@cascade.emadirect.md

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.

• Grady M. Hughes

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1417097031
  Medicare reassignment Care Compare group NPD
• Sharpevision PLLC

  • Ophthalmology Physician
  • Bellevue, WA
  • NPI 1164788279
  Medicare reassignment Care Compare group NPD
• Sharpevision PLLC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1295463990
  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1720090699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S. MERIDIAN",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S. MERIDIAN",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JERRY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00039681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8280638",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas N Shelton, D.O
• Tajinder Kaur Shergill, O.D.
• Catherine Joan Sherin-Terhune, LPN
• Diti Sheth
• Shield Carers LLC
• Helen H. Shigemitsu, M.D.
• Allen Shih, PHARM.D.
• Annette Shiley
• Lea Shim, DO
• Alex Shin, DMD

• Ophthalmology Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.