Active NPI
Nicholas Shashati, OD
- Optometrist
- Camillus, NY
National Provider Identifier
1881892115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4469
- Practice address
- 104 Kasson Rd
Camillus, NY 13031-2248 - Phone
- (315) 487-0327
- NPI assigned
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1728 | OR | |
| Optometrist | 152W00000X | OEG003367 | PA | |
| Optometrist | 152W00000X | 660 | AZ | |
| Optometrist | 152W00000X | 4469 | NY | Primary |
| Optometrist | 152W00000X | 730 | ND | |
| Optometrist | 152W00000X | 8124 | CA | |
| Optometrist | 152W00000X | 0618002615 | VA |
Addresses
Primary practice location
104 Kasson Rd
Camillus, NY 13031-2248
Mailing address
12228 Branicole LN
San Diego, CA 92129-5003
Other practice location 1
7007 Friars Rd Ste 667
San Diego, CA 92108-1155
Phone (858) 414-3513
Other practice location 2
9625 Black Mountain Rd
San Diego, CA 92126-4564
Phone (858) 831-9322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA, DC, VA, OR, CA, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 7
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1984
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Vermont Dr
New Hyde Park, NY 11042-1128
12228 Branicole LN
San Diego, CA 92129-5003
5 Dakota Dr
New Hyde Park, NY 11042-1107
5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1106
5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1188
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 730 | ND | MD | Chiropractor |
| 660 | AZ | MD | Optometrist |
| 8124 | CA | MD | Optometrist |
| 4469 | NY | MD | Optometrist |
| OEG003367 | PA | MD | Optometrist |
| 0618002615 | VA | MD | Optometrist |
| 1728 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downing Katz Optical Company Inc | Optometrist | Past | Accepting new patients |
| Visioncare of Californai | Optometrist | Past | Accepting new patients |
| Visioncare of California | Optometrist | Past | Accepting new patients |
Organizations & group practices 13
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.
-
- Optometrist
- Colorado Springs, CO
- NPI 1952301129
-
dba Eyes on Regent Square
- Optometrist
- Pittsburgh, PA
- NPI 1851958854
-
- Optometrist
- San Jose, CA
- NPI 1215627914
-
- Optometrist
- Camillus, NY
- NPI 1518626811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779840000000",
"number": "1881892115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12228 BRANICOLE LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921295003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 KASSON RD",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130312248",
"telephone_number": "315-487-0327"
}
],
"practiceLocations": [
{
"address_1": "7007 Friars Rd Ste 667",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921081155",
"country_code": "US",
"telephone_number": "858-414-3513",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9625 Black Mountain Rd",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921264564",
"country_code": "US",
"telephone_number": "858-831-9322",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHASHATI",
"first_name": "NICHOLAS",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-09",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1728",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG003367",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "660",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "4469",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ND",
"license": "730",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "8124",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618002615",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camillus, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.