Active NPI
Jeffery Robert Shiau, O.D.
- Optometrist
- Alhambra, CA
National Provider Identifier
1962840264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14614
- Practice address
- 2 W Main St
Alhambra, CA 91801-3552 - Phone
- (626) 282-3115
- Fax
- (626) 282-3463
- NPI assigned
- Jun 7, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14614 | CA | Primary |
Addresses
Primary practice location
2 W Main St
Alhambra, CA 91801-3552
Mailing address
2 W Main St
Alhambra, CA 91801-3552
Phone (626) 282-3115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962840264 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130719000254 | CA | Practitioner - Optometry | 6305087271 | Practice locations: Alhambra, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493251200000",
"number": "1962840264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W MAIN ST",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918013552",
"telephone_number": "626-282-3115",
"fax_number": "626-282-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W MAIN ST",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918013552",
"telephone_number": "626-282-3115",
"fax_number": "626-282-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIAU",
"first_name": "JEFFERY",
"middle_name": "ROBERT",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-07",
"last_updated": "2017-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1962840264",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.