Individual provider Active NPI

Peter Allen Shumway, OD

  • Optometrist
  • Sonora, CA
National Provider Identifier
1922147339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7575T Issued in CA
Practice address
13923 Mono Way
Sonora, CA 95370
Phone
(209) 533-2550
Fax
(209) 533-2951
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7575T CA Primary

Addresses

Primary practice location

13923 Mono Way
Sonora, CA 95370

Mailing address

13923 Mono Way
Sonora, CA 95370
Phone (209) 533-2550

Other identifiers 1

IdentifierTypeStateIssuer
SD0075750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120126000320 CA Practitioner - Optometry 1658548052 Reassigns benefits to 1 organization
Practice locations: Sonora, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
90.99
Improvement activities
40
Cost
61.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7575TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arthur N. Donaldson, M.D., Inc. Optometrist CurrentSince Jul 10, 2020 Accepting new patients
Arthur N Donaldson M D Inc CurrentSince Jul 10, 2020 Accepting new patients
Arthur N Donaldson M D Inc Past Accepting new patients

Locations

595 Stanislaus Ave
Ste A
Angels Camp, CA 95222
Phone (209) 736-5555

940 Sylva Ln
Ste J
Sonora, CA 95370
Phone (209) 532-2020

940 Sylva Ln
Ste G
Sonora, CA 95370
Phone (209) 532-0340

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922147339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13923 MONO WAY",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "95370",
            "telephone_number": "209-533-2550",
            "fax_number": "209-533-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13923 MONO WAY",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "95370",
            "telephone_number": "209-533-2550",
            "fax_number": "209-533-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMWAY",
        "first_name": "PETER",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7575T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0075750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.