Jeremy Ross Shumaker, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

13336T Issued in CA

Practice address

361 3Rd St Ste C
San Rafael, CA 94901-3580

Phone

(415) 459-2020

Fax

(415) 459-2021

NPI assigned

Jul 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

University of California - School of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of California at BerkeleyGroup PAC ID 8628083110, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshumaker348935@direct-ucsfmedicalcenter.org

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.

• Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
  • NPI 1306908058
  Medicare reassignment Care Compare group NPD
• Vision Academy SF- an Optometric Corp.

  dba Rising Star Optometry

  • Vision Therapy Optometrist
  • San Rafael, CA
  • NPI 1821666546

  Corneal and Contact Management

  NPD Authorized official

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

{
    "created_epoch": "1184976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1730389347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 3RD ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013580",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 3RD ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013580",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Tang Eye Center Third Floor University Health Services",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947203884",
            "country_code": "US",
            "telephone_number": "510-643-2020",
            "fax_number": "510-642-9422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "JEREMY",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-21",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "13336T",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "13336T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "13336T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "13336T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn M. Shore, M.D.
• Elizaveta Shostakovich, MD
• Barbara Shreibman, FNP
• Andrew Yu-Shin Shu
• Carolyn Beth Shulman, MSW, ACSW
• Jaydon Siao
• Steffi Sibal
• Regina Siciliano, DPT
• Side by Side
• Agyapal Sidhu

• Corneal and Contact Management Optometrist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.