Individual provider Active NPI

Adriana Shade, OD

  • Optometrist
  • Virginia Beach, VA
National Provider Identifier
1932929171
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003460 Issued in VA
Practice address
1255 Fordham Dr Ste 114
Virginia Beach, VA 23464-5347
Phone
(757) 523-0161
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003460 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1255 Fordham Dr Ste 114
Virginia Beach, VA 23464-5347

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20241218002829 VA Practitioner - Optometry 1658808415 Reassigns benefits to 1 organization
I20250403000704 NC Practitioner - Optometry 1658808415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

7020 Six Forks Rd
Raleigh, NC 27615-6430
Phone (919) 847-5957

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2855NCMDPsychologist
0618003460VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Nov 1, 2024 Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

6566 Glenwood Ave
Raleigh, NC 27612
Phone (919) 783-0011

13220 Strickland Rd
Ste 160
Raleigh, NC 27613
Phone (919) 870-6430

3905 New Bern Ave
Raleigh, NC 27610
Phone (919) 231-6040

7020 Six Forks Rd
Raleigh, NC 27615
Phone (919) 847-5957

8231 Brier Creek Pkwy
Raleigh, NC 27617
Phone (919) 863-5032

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1255 Fordham Dr
Ste 114
Virginia Beach, VA 23464
Phone (757) 523-0161

Organizations & group practices 6

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1932929171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 FORDHAM DR STE 114",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645347",
            "telephone_number": "757-523-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADE",
        "first_name": "ADRIANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003460",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.