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EYE SHOP PLLC
NPI 1538564984
Optometrist in Queen Creek, AZ

Active since October 28, 2014
21321 E OCOTILLO RD STE 105, QUEEN CREEK, AZ 85142(480) 656-7739(480) 656-1637 Get Directions Write a Review

NPPES record last updated: June 7, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Eye Shop Pllc NPPES

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

EYE SHOP PLLC (NPI 1538564984) is a healthcare organization registered as an optometrist in Queen Creek, Arizona and active in the NPI registry since October 2014. The organization lists Jared A Shaver, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1538564984
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameEYE SHOP PLLC
Location Address21321 E OCOTILLO RD STE 105Queen Creek, AZ 85142-5993
Mailing Address21321 E Ocotillo Rd Ste 105Queen Creek, AZ 85142-5993 · (480) 656-7739 · Fax (480) 656-1637
Phone(480) 656-7739
Fax(480) 656-1637
Organization SubpartNo
Authorized OfficialJared A ShaverSole Member · (480) 656-7739
Enumeration DateOctober 28, 2014
Last NPPES UpdateJune 7, 2020
NPPES CertifiedJune 7, 2020
✔ NPI 1538564984 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 AZ · 1706
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.
21321 E OCOTILLO RD STE 105, Queen Creek, AZ 85142
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eye Shop Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Eye Shop PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Eric Vanausdal, OD
Optometry
NPI 1255826681
21321 E OCOTILLO RD STE 105
Queen Creek, AZ 85142
(480) 656-7739
✔ PECOS✔ Accepts Medicare0.1 mi
Alma Yamamoto, O.D.
Optometry
NPI 1053624650
67 S HIGLEY RD STE 104
Gilbert, AZ 85296
(480) 219-5175
✔ PECOS✔ Accepts Medicare9.0 mi

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

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 Eye Shop PLLC's NPI number?

The NPI number for Eye Shop PLLC is 1538564984. It was assigned to this organization in the NPPES registry on October 28, 2014.

Where is Eye Shop PLLC located?

Eye Shop PLLC is located at 21321 E Ocotillo Rd Ste 105, Queen Creek, AZ 85142. The listed phone number is (480) 656-7739.

What is Eye Shop PLLC's specialty?

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

Is Eye Shop PLLC enrolled in Medicare?

Yes. Eye Shop PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eye Shop PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Eye Shop PLLC. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Eye Shop PLLC accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 5 other insurers list Eye Shop PLLC 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 Eye Shop PLLC was last updated on June 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.