Stuart Henry Shake, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002521 B Issued in IN

Practice address

6614 Logan Dr
Evansville, IN 47715-8236

Phone

(812) 477-6700

Fax

(812) 477-2152

NPI assigned

Mar 22, 2006

Last updated

Nov 5, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 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

Specialty

Optometry

Education

Illinois Medical College, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Kentucky Professional, PLLCGroup PAC ID 6204375165, 13 clinicians

Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Indiana Professional PC

  • Optometrist
  • Warsaw, IN
  • NPI 1043944127
  Medicare reassignment Care Compare group NPD
• Aeg Kentucky Professional, PLLC

  • Optometrist
  • Alton, IL
  • NPI 1467214080

  KY

  Medicare reassignment Care Compare group NPD
• First Impressions Optometric Associates, LLC

  • Optometrist
  • Bloomington, IN
  • NPI 1083366363
  Medicare reassignment NPD
• First Impressions Optometric Associates, LLC

  • Eyewear Supplier
  • Highland, IN
  • NPI 1942960539

  Optometrist

  NPD
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Louisville, KY
  • NPI 1275617276

  Optometrist

  NPD
• Owensboro Family Eye Care Center PSC

  • Optometrist
  • Owensboro, KY
  • NPI 1184683609
  NPD
• Dr Tabitha G Temple PC

  • Optometrist
  • Warsaw, IN
  • NPI 1851484125
  NPD (past)
• First Impressions Optometric Associates, LLC

  • Eyewear Supplier
  • Evansville, IN
  • NPI 1255091849

  Optometrist

  NPD (past)
• First Impressions Optometric Associates, LLC

  • Eyewear Supplier
  • Clarksville, IN
  • NPI 1417617101

  Optometrist

  NPD (past)
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Ashland, KY
  • NPI 1699086629

  Optometrist

  NPD (past)
• Tri-State Doctors of

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Owensboro, KY
  • NPI 1235415365

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1982663589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2199 LEDGEWOOD DR",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308057",
            "telephone_number": "812-858-1997",
            "fax_number": "812-477-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 LOGAN DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158236",
            "telephone_number": "812-477-6700",
            "fax_number": "812-477-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKE",
        "first_name": "STUART",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002521 B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Shotwell Seward, PT, DPT
• William C Seymour, MSW LCSW
• SH Indiana LLC (Senior Helpers of Southern IN)
• Himanshu Shah, M.D.
• Eman O Shahin, LCSW
• Andrew Dean Sharp, O.D.
• Taylor Sharp
• Anita C. Shaw, MSW
• Susan M Shaw, FNP
• Erin Elizabeth Sheeley, COTA

• Optometrist in Evansville, IN
• Providers in Evansville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.