Individual provider Active NPI

Matthew Shaw

  • Optician
  • Austin, TX
National Provider Identifier
1932916608
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
261378 Issued in TX
Practice address
13201 Ranch Road 620 N
Austin, TX 78717-1011
Phone
(512) 257-7678
Fax
(512) 257-7690
NPI assigned
Dec 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 261378 TX Primary

Addresses

Primary practice location

13201 Ranch Road 620 N
Austin, TX 78717-1011

Mailing address

13201 Ranch Road 620 N
Austin, TX 78717-1011
Phone (512) 257-7678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
261378TXMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1932916608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13201 RANCH ROAD 620 N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787171011",
            "telephone_number": "512-257-7678",
            "fax_number": "512-257-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13201 RANCH ROAD 620 N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787171011",
            "telephone_number": "512-257-7678",
            "fax_number": "512-257-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "261378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.