Steven H Shake, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1159DT Issued in KY

Practice address

3310 Professional Park
Suite 101
Owensboro, KY 42303-4551

Phone

(270) 683-2101

Fax

(270) 683-2507

NPI assigned

Mar 27, 2006

Last updated

Jul 27, 2012By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Kentucky Professional, PLLCGroup PAC ID 6204375165, 13 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Kentucky Professional, PLLC

  • Optometrist
  • Alton, IL
  • NPI 1467214080

  KY

  Medicare reassignment Care Compare group NPD
• Aeg Indiana Professional PC

  • Optometrist
  • Warsaw, IN
  • NPI 1043944127
  Medicare reassignment NPD
• Owensboro Family Eye Care Center PSC

  • Optometrist
  • Owensboro, KY
  • NPI 1184683609
  Medicare reassignment
• Dr Tabitha G Temple PC

  • Optometrist
  • Warsaw, IN
  • NPI 1851484125
  NPD (past)
• Vision Service Corporation

  dba Eye Mart

  • Optometrist
  • Evansville, IN
  • NPI 1831103290
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1922068386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 PROFESSIONAL PARK",
            "address_2": "SUITE 101",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034551",
            "telephone_number": "270-683-2101",
            "fax_number": "270-683-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 PROFESSIONAL PARK",
            "address_2": "SUITE 101",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034551",
            "telephone_number": "270-683-2101",
            "fax_number": "270-683-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKE",
        "first_name": "STEVEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1159DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000727",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas H Settles, PAC
• Falana Jaynel Sexton, CERTIFIED FIRST ASST
• Manilal B Shah, M.D.
• Satish K Shah, MD
• Umang Shah
• Lauren Christine Shan, DPT
• Devon Michelle Shaut
• Stephanie Aline Shaver, CSW
• William Douglas Shaver, DMD
• Shaw & Wiederhold PSC

• Optometrist in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.