JACKSON CADE SHETLAR OD
NPI 1205674389
Optometrist in Salina, KS

Q: What is Jackson Shetlar's NPI number?

The NPI number for Jackson Shetlar is 1205674389. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Q: What is Jackson Shetlar's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jackson Shetlar was last updated on July 18, 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.

Active since July 15, 2024PECOS EnrolledAccepts Medicare Assignment

1601 E IRON AVE, SALINA, KS 67401(785) 825-4679(785) 825-5898 Get Directions Write a Review

NPPES record last updated: July 18, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Jackson Cade Shetlar Od NPPES

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

JACKSON CADE SHETLAR OD (NPI 1205674389) is an individual optometrist in Salina, Kansas, licensed in Kansas (2231) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1205674389

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameJACKSON CADE SHETLARCredential: OD

Location Address1601 E IRON AVESalina, KS 67401-3237

Mailing Address1601 E Iron AveSalina, KS 67401-3237 · (785) 825-4679 · Fax (785) 825-5898

Phone(785) 825-4679

Fax(785) 825-5898

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 15, 2024

Last NPPES UpdateJuly 18, 2024

NPPES CertifiedJuly 18, 2024

✔ NPI 1205674389 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 KS · 2231

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.

1601 E IRON AVE, Salina, KS 67401

Open in Google Maps ↗

Secondary Practice Location 1

Location 1407 W 2nd StMinneapolis, KS 67467-2315 · Phone (785) 392-2126 · Fax (785) 392-2180

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..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

Jackson Cade Shetlar Od 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 ID1557809233

PECOS Enrollment IDI20240813001194

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 Reassignment

Medicare enrollment records show Jackson Shetlar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Drs Driver & Clark PA

Same address

Optometrist

1601 E IRON AVE
Salina, KS 67401

Reassigned Medicare billing, Kansas enrollment
4 clinicians in this Medicare group

NPI 1811076060 (785) 825-4679

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 6

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.

39 services39 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.

28 services26 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.

21 services21 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.

19 services19 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

13 services13 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.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 67401 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

$122.41 typical visit price

range $53.00 – $161.67

Typical copayment $30.60 (range $13.25 – $40.41)

Most-billed visit code 99204

Established Patient

$66.40 typical visit price

range $16.88 – $132.11

Typical copayment $16.60 (range $4.22 – $33.02)

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 4

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

DR. ERIN TONGOUN SMITH O.D.

Optometrist

1601 E IRON AVE
SALINA, KS 67401

Saline County (785) 825-4679

DR. KENTON RAY DRIVER OD

Optometrist

1601 E IRON AVE
SALINA, KS 67401

Saline County (785) 825-4679

DRS DRIVER & CLARK PA

Optometrist

1601 E IRON AVE
SALINA, KS 67401

Saline County (785) 825-4679

DR. STACY ANN CLARK OD

Optometrist

1601 E IRON AVE
SALINA, KS 67401

Saline County (785) 825-4679

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 Jackson Shetlar's NPI number?

The NPI number for Jackson Shetlar is 1205674389. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Where is Jackson Shetlar located?

Jackson Shetlar practices at 1601 E Iron Ave, Salina, KS 67401. The listed phone number is (785) 825-4679.

What is Jackson Shetlar's specialty?

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

Is Jackson Shetlar enrolled in Medicare?

Yes. Jackson Shetlar 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 organization bills Medicare for Jackson Shetlar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jackson Shetlar reassigns Medicare benefits to Drs Driver & Clark PA (Salina, KS). The 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 Jackson Shetlar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jackson Shetlar accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Jackson Shetlar 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 Jackson Shetlar was last updated on July 18, 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.