Hailey Sarah Shaffer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004018 Issued in IN

Practice address

501 W Broadway St
Monticello, IN 47960-2006

Phone

(574) 583-9311

Fax

(574) 583-4939

NPI assigned

Apr 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Hailey Sarah Williams Other name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evans Eye Care IncGroup PAC ID 9830169234, 33 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hailey.shaffer@direct.revolutionehr.com

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.

• Evans Eye Care Inc

  • Optometrist
  • Lafayette, IN
  • NPI 1992784599
  Medicare reassignment Care Compare group NPD
• Duane a Gillam

  • Optometrist
  • Lafayette, IN
  • NPI 1902045446
  NPD (past)
• Eyecare Experience, LLC

  • Optometrist
  • Lafayette, IN
  • NPI 1922211549
  NPD (past)

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1992238422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602006",
            "telephone_number": "574-583-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602006",
            "telephone_number": "574-583-9311",
            "fax_number": "574-583-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "HAILEY",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAILEY",
            "last_name": "WILLIAMS",
            "middle_name": "SARAH",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.