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DR. SHANE M JOHNSTON O.D.
NPI 1356791545
Optometrist in Mesa, AZ

Active since June 17, 2016PECOS EnrolledAccepts Medicare Assignment
1940 S COUNTRY CLUB DR STE 102, MESA, AZ 85210(480) 834-6367(480) 834-7277 Get Directions Write a Review

NPPES record last updated: June 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 5, 2026, Jun 20, 2016, Jun 17, 2016 (3 updates tracked since 2016).

About Dr. Shane M Johnston O.d. NPPES

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

DR. SHANE M JOHNSTON O.D. (NPI 1356791545) is an individual optometrist in Mesa, Arizona, licensed in Arizona (2108) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1356791545
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. SHANE M JOHNSTONCredential: O.D.
Location Address1940 S COUNTRY CLUB DR STE 102Mesa, AZ 85210-6042
Mailing Address8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442 · (703) 847-8899
Phone(480) 834-6367
Fax(480) 834-7277
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 17, 2016
Last NPPES UpdateJune 5, 20263 updates tracked since enumeration
NPPES CertifiedJune 5, 2026
✔ NPI 1356791545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in AZ · 2108
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.
Also ListedOptometrist · Sports VisionTaxonomy 152WS0006X · License 2108 (AZ)
1940 S COUNTRY CLUB DR STE 102, Mesa, AZ 85210
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana 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

Dr. Shane M Johnston O.d. 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 ID9133468754
PECOS Enrollment IDI20260312003843
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 Shane Johnston reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Myeyedr Optometry Of Washington, PLLC
Same address
Optometrist
1940 S COUNTRY CLUB DR STE 102
Mesa, AZ 85210
  • Reassigned Medicare billing, Arizona enrollment
  • 82 clinicians in this Medicare group
NPI 1437015005 (480) 834-6367
Kirk T Reed O D P C
15 mi
Optometrist
20715 E OCOTILLO RD STE 101
Queen Creek, AZ 85142
  • Reassigned Medicare billing, Arizona enrollment
  • 2 clinicians in this Medicare group
NPI 1750522876 (480) 987-3400

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85210 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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. FRED NMN FISCH O.D.
Optometrist
1940 S COUNTRY CLUB DR STE 102
MESA, AZ 85210
Maricopa County (480) 834-6367
MYEYEDR OPTOMETRY OF WASHINGTON, PLLC
Optometrist
1940 S COUNTRY CLUB DR STE 102
MESA, AZ 85210
Maricopa County (480) 834-6367
TAYLOR LYNN COONS OD
Optometrist
1940 S COUNTRY CLUB DR STE 102
MESA, AZ 85210
Maricopa County (480) 834-6367
DR. BRITTANY MICHELLE MOHNING OD
Optometrist
1940 S COUNTRY CLUB DR STE 102
MESA, AZ 85210
Maricopa County (480) 834-6367

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 Shane Johnston's NPI number?

The NPI number for Shane Johnston is 1356791545. It was assigned to this individual provider in the NPPES registry on June 17, 2016.

Where is Shane Johnston located?

Shane Johnston practices at 1940 S Country Club Dr Ste 102, Mesa, AZ 85210. The listed phone number is (480) 834-6367.

What is Shane Johnston's specialty?

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

Is Shane Johnston enrolled in Medicare?

Yes. Shane Johnston 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 Shane Johnston's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Johnston reassigns Medicare benefits to 2 organizations: Myeyedr Optometry Of Washington, PLLC (Mesa, AZ) and Kirk T Reed O D P C (Queen Creek, AZ). 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 Shane Johnston's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shane Johnston accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 9 other insurers list Shane Johnston 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 Shane Johnston was last updated on June 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.