Kim Ray Shrum, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

L2649 Issued in TX

Practice address

18545 W Lake Houston Pkwy
Humble, TX 77346-3392

Phone

(281) 812-4000

Fax

(281) 812-3331

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Eastern Virginia Medical School, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berkeley Eye Institute, PLLCGroup PAC ID 4082602156, 62 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.82 of 100Reported as group

Quality

81.48

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshrum@direct.uspi.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.

• Berkeley Eye Institute, PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1740286186
  Medicare reassignment Care Compare group NPD
• Berkeley Eye Institute, PLLC

  • Ophthalmology Physician
  • Dayton, TX
  • NPI 1346082872
  NPD
• Clear Lake Eye Center LLP

  • Optometrist
  • Houston, TX
  • NPI 1255338612
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1902895568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18545 W LAKE HOUSTON PKWY",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463392",
            "telephone_number": "281-812-4000",
            "fax_number": "281-812-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18545 W LAKE HOUSTON PKWY",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463392",
            "telephone_number": "281-812-4000",
            "fax_number": "281-812-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRUM",
        "first_name": "KIM",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L2649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145199904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145199905",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PALMETTO",
            "identifier": "4198390002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7114117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECHSTREET",
            "identifier": "21210202328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN FIRST HEALTH",
            "identifier": "5248990",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8B7450",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "975250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4119904",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PALMETTO",
            "identifier": "4198390001",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kray.shrum@direct.berkeleyeye.com",
            "affiliation": "Y",
            "affiliationName": "Berkeley Eye Institute, PLLC",
            "address_1": "18545 W LAKE HOUSTON PKWY",
            "city": "HUMBLE",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773463392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Diana Asucena Sifuentes, MS, EP-C
• Anne Michelle Simmons
• Ashley Mitchell Simmons, COTA
• Kalendria Simmons

• Ophthalmology Physician in Humble, TX
• Providers in Humble, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.