MONICA SHEAFFER O.D.
NPI 1255361705
Optometrist in Baltimore, MD
NPI Status: Active since July 03, 2006
Contact Information
4940 EASTERN AVE
BALTIMORE, MD
ZIP 21224
Phone: (410) 550-2360
- Individual
- Female
- Optometrist
- PECOS Enrolled
About MONICA SHEAFFER
This page provides the complete NPI Profile along with additional information for Monica Sheaffer, a provider established in Baltimore, Maryland with a medical specialization in Optometrist. The healthcare provider is registered in the NPI registry with number 1255361705 assigned on July 2006. The practitioner's primary taxonomy code is 152W00000X with license number TA1205 (MD). The provider is registered as an individual and her NPI record was last updated 12 years ago.
- NPI
- 1255361705
- Provider Name
- MONICA SHEAFFER O.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4940 EASTERN AVE BALTIMORE, MD 21224
- Location Phone
- (410) 550-2360
- Mailing Address
- PO BOX 64481 BALTIMORE, MD 21264
- Mailing Phone
- (410) 550-5401
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-03-2006
- Last Update Date
- 02-18-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- TA1205
- License State
- MD
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
102198200 | MEDICAID (05) | MD | |
KR84C121 | MEDICARE PIN (08) | MD | |
U48217 | MEDICARE UPIN (02) | MD |
Medicare Participation & PECOS Enrollment Status
Monica Sheaffer is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Exam of visual field with extended testing
Imaging of optic nerve
Imaging of retina
New patient office or other outpatient visit, 30-44 minutes
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 30 times for 29 patientsThis 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.
This service was performed 179 times for 174 patientsAn 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.
This service was performed 27 times for 26 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 39 times for 35 patientsImaging 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.
This service was performed 54 times for 51 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 87 times for 87 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 21224 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $139.05
- Minimum New Patient Price $60.73
- Maximum New Patient Price $183.44
- Average New Patient Copayment $34.76
- Minimum New Patient Copayment $15.18
- Maximum New Patient Copayment $45.86
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.47
- Minimum Established Patient Price $19.6
- Maximum Established Patient Price $149.17
- Average Established Patient Copayment $18.86
- Minimum Established Patient Copayment $4.9
- Maximum Established Patient Copayment $37.29
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for MONICA SHEAFFER O.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 2 | 5 | 5 | 3 | 6 | 1 | 7 | 0 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 10 | 5 | 6 | 6 | 2 | 7 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 1 + 0 + 5 + 6 + 6 + 2 + 7 + 0 + 24 = 55 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 55 = 5 | 5 |
The NPI number 1255361705 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1316901903 | HAROLD J ALFERT M.D. Individual | Urology | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-7008 |
1548224439 | DANA KIMBALL ANDERSEN M.D. Individual | Surgery | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0400 |
1568427342 | CAROLYN SHARON BACAL P.A.-C. Individual | Physician Assistant | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-5633 |
1639134299 | HIBA M BARGHOUTHI M.D. Individual | Internal Medicine (Nephrology) | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0979 |
1487619052 | LISA ANN BARKEY P.A.-C. Individual | Physician Assistant | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-1215 |
1346205051 | COLLEEN HOWLAND PA-C Individual | Physician Assistant | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-5864 |
1639134810 | SUSAN ELAINE BAILEY M.D. Individual | Psychiatry & Neurology (Psychiatry) | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0018 |
1013972918 | ANNA MAE BECKER C.P.N.P. Individual | Nurse Practitioner | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0967 |
1265498927 | GEORGE E BIGELOW P.H.D. Individual | Psychologist | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0035 |
1629034590 | EDWARD S BESSMAN M.D. Individual | Emergency Medicine | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0350 |
1346206034 | HENRY W BOFFEN JR. C.R.N.A. Individual | Nurse Anesthetist, Certified Registered | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 955-6353 |
1508822651 | ROMSAI T BOONYASAI M.D. Individual | Internal Medicine | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-9434 |
1962468991 | ROBIN BOYNTON C.R.N.A. Individual | Nurse Anesthetist, Certified Registered | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 955-6353 |
1598722217 | KAREN BOLLA P.H.D. Individual | Psychologist (Clinical) | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-5624 |
1477510808 | STEPHANIE RUTH MARTINDALE P.A. Individual | Physician Assistant (Medical) | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0500 |
1760440010 | JOHN TIMOTHY CAMPBELL M.D. Individual | Orthopaedic Surgery | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-5397 |
1396703880 | JAMES F BURDICK M.D. Individual | Surgery | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0400 |
1831157320 | ANNE ELIZABETH BURKE M.D. Individual | Obstetrics & Gynecology | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-7802 |
1740239847 | PATRICIA K. MAZIKAS P.A. Individual | Physician Assistant | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0350 |
1043269053 | DR. SHARON HANDEL M.D. Individual | Psychiatry & Neurology (Psychiatry) | 4940 EASTERN AVE BALTIMORE, MD 21224 (410) 550-0018 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255361705, enumerated in the NPI registry as an "individual" on July 03, 2006
The provider is located at 4940 Eastern Ave Baltimore, Md 21224 and the phone number is (410) 550-2360
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $139.05 with an average copayment of $34.76 for new patient appointments. Established patients should expect a typical charge of $75.47 and an average copayment of 18.86. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 20-29 minutes, Exam of visual field with extended testing, Imaging of optic nerve, Imaging of retina and New patient office or other outpatient visit, 30-44 minutes.
This NPI record was last updated on July 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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