Individual provider Active NPI

Susan Elizabeth Shauger, O.D.

  • Optometrist
  • Cedar Park, TX
National Provider Identifier
1881640944
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6257TG Issued in TX
Practice address
3419 El Salido Pkwy Ste 100
Cedar Park, TX 78613-5634
Phone
(512) 918-3937
Fax
(512) 918-2028
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6257TG TX Primary

Addresses

Primary practice location

3419 El Salido Pkwy Ste 100
Cedar Park, TX 78613-5634

Mailing address

3419 El Salido Pkwy Ste 100
Cedar Park, TX 78613-5639
Phone (512) 918-3937

Other identifiers 1

IdentifierTypeStateIssuer
6257TGOtherTXTEXAS OPTOMETRY BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070524000062 TX Practitioner - Optometry 2769426022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeline Vision, P.C.Group PAC ID 0244227486, 10 clinicians

Practice addresses (Care Compare)

3419 El Salido Pkwy
Suite 100
Cedar Park, TX 78613-5639
Phone (512) 918-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6257TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeline Vision, P.C. Optometrist CurrentSince Jun 2, 2006 Accepting new patients
Dr. Kenneth O'Daniel & Assoc., PC Optometrist Past Accepting new patients
Diabetic Eye Care Specialists LLC Optometrist PastSince Jun 21, 2020 Accepting new patients

Locations

3419 El Salido Pkwy
Ste 100
Cedar Park, TX 78613
Phone (512) 918-3937

Organizations & group practices 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881640944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 EL SALIDO PKWY STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135639",
            "telephone_number": "512-918-3937",
            "fax_number": "512-918-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 EL SALIDO PKWY STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135634",
            "telephone_number": "512-918-3937",
            "fax_number": "512-918-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGER",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-03-07",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6257TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY BOARD",
            "identifier": "6257TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.