Jennifer Marie Shade, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35123554 Issued in OH

Practice address

89 Sylvania Dr
Beavercreek, OH 45440-3281

Phone

(937) 320-2020

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jennifer Marie Jaworski Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

University of Cincinnati College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cei Physicians PSC, LLCGroup PAC ID 0749186427, 155 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.01 of 100Reported as apm

Quality

86.02

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.shade.p1@direct.cei.nextgenshare.com

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.

• Cei Physicians PSC LLC

  • Ophthalmology Physician
  • Cincinnati, OH
  • NPI 1942296298
  Medicare reassignment Care Compare group NPD
• Cei Physicians PSC, LLC

  • Ambulatory Surgical Clinic/Center
  • Richmond Heights, OH
  • NPI 1891406328
  NPD
• Cei Physicians PSC LLC

  • Ophthalmologic Surgery Clinic/Center
  • Blue Ash, OH
  • NPI 1790772804
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1801028600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403281",
            "telephone_number": "937-320-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403281",
            "telephone_number": "937-320-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "56584",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35123554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JAWORSKI",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Craig Seim
• Joshua Dale Sensenbaugh, PSYD
• Serenity Now Home Care, LLC
• Elizabeth Serra-Hsu, MD
• Alia Shaban
• Maxwell Shafer, MD
• Anjana Hemant Shah, MD
• Mohammed D Shahid, DPM
• Shamim Shamsi, M.D
• Charles Shanesy III, PT

• Ophthalmology Physician in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.