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DR. PHILIP SHAFFER O.D.
NPI 1205188844
Optometrist in Cumming, GA

Active since October 05, 2012PECOS Enrolled
90.64/100
CMS Quality Rating
1230 BALD RIDGE MARINA RD STE 100, CUMMING, GA 30041(770) 292-1999 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Philip Shaffer O.d. NPPES

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

DR. PHILIP SHAFFER O.D. (NPI 1205188844) is an individual optometrist in Cumming, Georgia, licensed in Georgia (OPT003486) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205188844
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. PHILIP SHAFFERCredential: O.D.
Location Address1230 BALD RIDGE MARINA RD STE 100Cumming, GA 30041-7950
Mailing Address1230 Bald Ridge Marina Rd Ste 100Cumming, GA 30041-7950
Phone(770) 292-1999
Sole ProprietorNo
Enumeration DateOctober 5, 2012
Last NPPES UpdateJune 13, 2024
NPPES CertifiedJune 13, 2024
✔ NPI 1205188844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in GA · OPT003486✔ Licensed in IN · 18003734A
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.
1230 BALD RIDGE MARINA RD STE 100, Cumming, GA 30041
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Philip Shaffer O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Areas of Expertise CMS Part B claims 11

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 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.
219 services211 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
198 services195 patients
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.
186 services150 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
118 services105 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
108 services97 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.
104 services96 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost68.82

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 Philip Shaffer's NPI number?

The NPI number for Philip Shaffer is 1205188844. It was assigned to this individual provider in the NPPES registry on October 5, 2012.

Where is Philip Shaffer located?

Philip Shaffer practices at 1230 Bald Ridge Marina Rd Ste 100, Cumming, GA 30041. The listed phone number is (770) 292-1999.

What is Philip Shaffer's specialty?

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

Is Philip Shaffer enrolled in Medicare?

Yes. Philip Shaffer is registered in the Medicare PECOS enrollment system.

What insurance does Philip Shaffer accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan and Ambetter from Meridian and 10 other insurers list Philip Shaffer 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 Philip Shaffer was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.