Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. LYSLE SHAW-MCMINN O.D.
NPI 1720481641
Optometrist in Riverside, CA

Q: What is Lysle Shaw-mcminn's NPI number?

The NPI number for Lysle Shaw-mcminn is 1720481641. It was assigned to this individual provider in the NPPES registry on October 6, 2014.

Q: What is Lysle Shaw-mcminn'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 Lysle Shaw-mcminn was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days 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 October 06, 2014PECOS Enrolled

16327 SALLY LN, RIVERSIDE, CA 92504(951) 672-4971 Get Directions Write a Review

NPPES record last updated: August 21, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Lysle Shaw-mcminn O.d. NPPES

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

DR. LYSLE SHAW-MCMINN O.D. (NPI 1720481641) is an individual optometrist in Riverside, California, licensed in California (15133) and active in the NPI registry since October 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720481641

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. LYSLE SHAW-MCMINNCredential: O.D.

Location Address16327 SALLY LNRiverside, CA 92504-5639

Mailing Address16327 Sally LnRiverside, CA 92504-5639 · (951) 672-4971

Phone(951) 672-4971

Sole ProprietorYes

Enumeration DateOctober 6, 2014

Last NPPES UpdateAugust 21, 2026

NPPES CertifiedAugust 21, 2026

✔ NPI 1720481641 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 CA · 15133

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.

16327 SALLY LN, Riverside, CA 92504

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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. Lysle Shaw-mcminn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92504 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

$136.04 typical visit price

range $59.60 – $179.42

Typical copayment $34.01 (range $14.90 – $44.85)

Most-billed visit code 99204

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

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.

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 Lysle Shaw-mcminn's NPI number?

The NPI number for Lysle Shaw-mcminn is 1720481641. It was assigned to this individual provider in the NPPES registry on October 6, 2014.

Where is Lysle Shaw-mcminn located?

Lysle Shaw-mcminn practices at 16327 Sally Ln, Riverside, CA 92504. The listed phone number is (951) 672-4971.

What is Lysle Shaw-mcminn's specialty?

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

Is Lysle Shaw-mcminn enrolled in Medicare?

Yes. Lysle Shaw-mcminn is registered in the Medicare PECOS enrollment system.

What insurance does Lysle Shaw-mcminn accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Lysle Shaw-mcminn 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 Lysle Shaw-mcminn was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days 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.