Individual provider Active NPI

Shane Alan Stevens, OD

  • Optometrist
  • Guilderland, NY
National Provider Identifier
1720558661
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0982 Issued in NH
Practice address
2050 Western Ave Ste 106
Guilderland, NY 12084-9563
Phone
(518) 456-6000
Fax
(518) 456-3426
NPI assigned
Dec 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0982 NH Primary

Addresses

Primary practice location

2050 Western Ave Ste 106
Guilderland, NY 12084-9563

Mailing address

2050 Western Ave Ste 106
Guilderland, NY 12084-9563
Phone (518) 456-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Shane.Stevens@direct.revolutionehr.com Direct

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
I20241029001446 NY Practitioner - Optometry 1658606751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Care IncGroup PAC ID 3779819859, 5 clinicians

Practice addresses (Care Compare)

2050 Western Ave
Suite 106
Guilderland, NY 12084-9563
Phone (518) 456-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0982NHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Care, Inc. Optometrist CurrentSince Aug 22, 2024 Accepting new patients

Locations

2050 Western Ave
Ste 106
Guilderland, NY 12084
Phone (518) 456-6000

Interoperability endpoints

  • Direct secure messaging: shane.stevens@direct.revolutionehr.com

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1720558661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 WESTERN AVE STE 106",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "120849563",
            "telephone_number": "518-456-6000",
            "fax_number": "518-456-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 WESTERN AVE STE 106",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "120849563",
            "telephone_number": "518-456-6000",
            "fax_number": "518-456-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SHANE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-04",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shane.Stevens@direct.revolutionehr.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "272 Cottage St",
            "city": "Sanford",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040731815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Guilderland, NY

Sources for this page

Verify at the official NPI Registry.