Individual provider Active NPI

Julie Shah

  • Optometrist
  • New York, NY
National Provider Identifier
1962875542
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008375-1 Issued in NY
Practice address
551 5TH Ave
New York, NY 10176-3373
Phone
(212) 791-4000
NPI assigned
Nov 4, 2015
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00664300 NJ
Optometrist 152W00000X TUV008375-1 NY Primary

Addresses

Primary practice location

551 5TH Ave
New York, NY 10176-3373

Mailing address

551 5TH Ave
New York, NY 10176-3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160516001244 NY Practitioner - Optometry 5092004044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Town Optical IncGroup PAC ID 9830088053, 5 clinicians

Practice addresses (Care Compare)

551 5TH Ave
FL 2
New York, NY 10176-0001
Phone (212) 719-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00664300NJMDOptometrist
TUV008375-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Town Optical Optometrist CurrentSince Mar 21, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1962875542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101763373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101763373",
            "telephone_number": "212-791-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00664300",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008375-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.