Individual provider Active NPI

Shelby Delrae Rookstool, OPTOMETRIST

  • Optometrist
  • MC Cook, NE
National Provider Identifier
1912569443
Registry record updated Jul 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1505 Issued in NE
Practice address
212 W 9TH St
MC Cook, NE 69001-3515
Phone
(308) 345-2954
Fax
(308) 345-7719
NPI assigned
Jul 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1505 NE Primary

Addresses

Primary practice location

212 W 9TH St
MC Cook, NE 69001-3515

Mailing address

424 Norris Ave Apt 204
MC Cook, NE 69001-2054
Phone (308) 520-4837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20190716002284 NE Practitioner - Optometry 0042545808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Family Vision Clinic LLCGroup PAC ID 8628393915, 3 clinicians

Practice addresses (Care Compare)

212 W 9TH St
MC Cook, NE 69001-3515
Phone (308) 345-2954

Hospital & facility affiliations

  • Sidney Regional Medical Center Hospital, Sidney, NE, CCN 281357

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Family Vision Clinic LLC Optometrist CurrentSince Jul 5, 2019 Accepting new patients
Burrows Vision Clinic LLC Optometrist PastSince Jul 5, 2019 Accepting new patients

Locations

212 W 9th St
McCook, NE 69001
Phone (308) 345-2954

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562198400000",
    "number": "1912569443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 NORRIS AVE APT 204",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690012054",
            "telephone_number": "308-520-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 9TH ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013515",
            "telephone_number": "308-345-2954",
            "fax_number": "308-345-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOKSTOOL",
        "first_name": "SHELBY",
        "middle_name": "DELRAE",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-04",
        "last_updated": "2019-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Cook, NE

Sources for this page

Verify at the official NPI Registry.