Individual provider Active NPI

Sarah Ann Shaw, O.D.

  • Optometrist
  • Warsaw, NY
National Provider Identifier
1720492440
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008254 Issued in NY
Practice address
2469 State Route 19 N
Warsaw, NY 14569-9336
Phone
(585) 786-2288
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008254 NY Primary

Addresses

Primary practice location

2469 State Route 19 N
Warsaw, NY 14569-9336

Mailing address

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-2288

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150706000035 NY Practitioner - Optometry 1254552029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah a Shaw OD Optometrist PLLCGroup PAC ID 2668703752, 2 clinicians

Practice addresses (Care Compare)

215 E Ave
Lockport, NY 14094-3812
Phone (716) 434-2874

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah a Shaw OD Optometrist PLLC Optometrist CurrentSince Aug 14, 2019 Accepting new patients
East Avenue Vision Center PastSince Aug 14, 2019 Accepting new patients

Locations

215 East Ave
Lockport, NY 14094
Phone (716) 434-2874

Organizations & group practices 2

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1720492440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SARAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

Verify at the official NPI Registry.