Individual provider Active NPI

Shakil Mustafa Syed, OD

  • Optometrist
  • Easton, PA
National Provider Identifier
1871565028
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001631 Issued in PA
Practice address
4080 Hunter CT
Easton, PA 18045
Phone
(717) 343-4373
NPI assigned
Feb 2, 2006
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001631 PA Primary

Addresses

Primary practice location

4080 Hunter CT
Easton, PA 18045

Mailing address

4080 Hunter CT
Easton, PA 18045
Phone (717) 505-7914

Other identifiers 1

IdentifierTypeStateIssuer
1015157790001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20061115000246 PA Practitioner - Optometry 9234137860 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

440 W Lincoln St
Easton, PA 18042-6519
Phone (610) 224-0898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001631PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Mar 30, 2020 Accepting new patients
Independence Corporation Optometrist CurrentSince May 4, 2009 Accepting new patients
Visionworks, Inc CurrentSince Mar 30, 2020 Accepting new patients
Independence Corporation Optometrist CurrentSince May 4, 2009 Accepting new patients

Locations

949 Airport Center Dr
Allentown, PA 18109
Phone (610) 264-0891

1900 W Front St
Berwick, PA 18603
Phone (570) 759-2325

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

2274 MacArthur Rd
Whitehall, PA 18052
Phone (610) 432-3937

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1871565028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 HUNTER CT",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "18045",
            "telephone_number": "717-505-7914",
            "fax_number": "717-343-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 HUNTER CT",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "18045",
            "telephone_number": "717-343-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "SHAKIL",
        "middle_name": "MUSTAFA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015157790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.