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SHAIL GAJJAR
NPI 1093403933
Optometrist in Houston, TX

Active since April 27, 2023PECOS EnrolledAccepts Medicare Assignment
5115 FANNIN ST STE 1000, HOUSTON, TX 77004(713) 580-2500 Get Directions Write a Review

NPPES record last updated: July 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Shail Gajjar NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAIL GAJJAR (NPI 1093403933) is an individual optometrist in Houston, Texas, licensed in Texas (10848TG) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of University Of Houston - College Of Optometry (2023).

NPPES Registry Identity

NPI1093403933
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameSHAIL GAJJAR
Location Address5115 FANNIN ST STE 1000Houston, TX 77004-5899
Mailing Address4856 Palomar LnLeague City, TX 77573-1586
Phone(713) 580-2500
Sole ProprietorNo
Medical School CMSUniversity Of Houston - College Of OptometryGraduated 2023
Enumeration DateApril 27, 2023
Last NPPES UpdateJuly 13, 2025
NPPES CertifiedJuly 13, 2025
✔ NPI 1093403933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in TX · 10848TG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
5115 FANNIN ST STE 1000, Houston, TX 77004
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shail Gajjar is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739548751
PECOS Enrollment IDI20240613003627
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shail Gajjar reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mann Eye Center, PA
Same address
Clinic/Center
5115 FANNIN ST STE 1000
Houston, TX 77004
  • Reassigned Medicare billing, Texas enrollment
  • 51 clinicians in this Medicare group
NPI 1629081799 (713) 580-2500
University Of Houston System
2.4 mi
Speech-Language Pathologist
100 CLINIC RESEARCH SERVICES
Houston, TX 77204
  • Reassigned Medicare billing, Texas enrollment
  • 75 clinicians in this Medicare group
NPI 1447371430 (713) 743-2898

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
27 services25 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
19 services17 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
17 services17 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
12 services12 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TATIANA NOROOZIAN OD
Optometrist
5115 FANNIN ST STE 1000
HOUSTON, TX 77004
Harris County (713) 580-2500
MS. CLAIRE H CHANG MD PA
Ophthalmology
5115 FANNIN ST STE 1000
HOUSTON, TX 77004
Harris County (713) 580-2500
MANN EYE CENTER, PA
Clinic/Center
5115 FANNIN ST STE 1000
HOUSTON, TX 77004
Harris County (713) 580-2500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shail Gajjar's NPI number?

The NPI number for Shail Gajjar is 1093403933. It was assigned to this individual provider in the NPPES registry on April 27, 2023.

Where is Shail Gajjar located?

Shail Gajjar practices at 5115 Fannin St Ste 1000, Houston, TX 77004. The listed phone number is (713) 580-2500.

What is Shail Gajjar's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Shail Gajjar enrolled in Medicare?

Yes. Shail Gajjar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shail Gajjar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shail Gajjar reassigns Medicare benefits to 2 organizations: Mann Eye Center, PA (Houston, TX) and University Of Houston System (Houston, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shail Gajjar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shail Gajjar accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 17 other insurers list Shail Gajjar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shail Gajjar was last updated on July 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.