DAVID A SHIPLE M.D.
NPI 1780828533
Ophthalmology in Rochester, NY


Quality Rating: 85.11 out of 100 score

NPI Status: Active since April 23, 2009

Contact Information

601 ELMWOOD AVE
BOX 659
ROCHESTER, NY
ZIP 14642
Phone: (585) 273-3937
Fax: (585) 506-0192

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  • Individual
  • Male
  • Years of Experience 17
  • Ophthalmology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DAVID SHIPLE

This page provides the complete NPI Profile along with additional information for David Shiple, a provider established in Rochester, New York with a medical specialization in Ophthalmology and more than 17 years of experience. He graduated from Ohio State University College Of Medicine in 2009. The healthcare provider is registered in the NPI registry with number 1780828533 assigned on April 2009. The practitioner's primary taxonomy code is 207W00000X with license number 270012 (NY). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1780828533
Provider Name
DAVID A SHIPLE M.D.
Gender
Male
Entity Type
Individual
Location Address
601 ELMWOOD AVE BOX 659 ROCHESTER, NY 14642
Location Phone
(585) 273-3937
Location Fax
(585) 506-0192
Mailing Address
601 ELMWOOD AVE BOX 659 ROCHESTER, NY 14642
Mailing Phone
(585) 273-3937
Mailing Fax
(585) 506-0192
Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year
2009
Is Sole Proprietor?
Yes
Enumeration Date
04-23-2009
Last Update Date
03-29-2016
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Ophthalmologists like David Shiple specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

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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

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
License No.
270012
License State
NY
Taxonomy Description
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

042.0013402 (VT)
2390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
  • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
  • Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
  • Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
  • Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
  • Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
  • Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

David Shiple is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Shiple 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), a Home Health Agency (HHA) and Power Mobility Devices.

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

  • PECOS PAC ID: 7517100597

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20160713000095

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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: Yes

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.

Cataract surgery

Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.

This service was performed for 525 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 19 times for 17 patients

Established patient complete exam of visual system

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.

This service was performed 454 times for 429 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 345 times for 246 patients

Established patient problem focused exam of visual system

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

This service was performed 371 times for 248 patients

Exam of the internal drainage system of eye

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

This service was performed 16 times for 16 patients

Exam of visual field with extended testing

An 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 317 times for 247 patients

Imaging of optic nerve

Imaging 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 317 times for 267 patients

Imaging of retina

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.

This service was performed 135 times for 104 patients

Measurement of corneal curvature and depth of eye

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

This service was performed 295 times for 200 patients

New patient complete exam of visual system

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.

This service was performed 48 times for 48 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 148 times for 148 patients

Photography of the retina

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.

This service was performed 71 times for 70 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 283 times for 184 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 48 times for 44 patients

Ultrasound scan of cornea to determine thickness

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

This service was performed 54 times for 54 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $17.14 for an established patient copayment.

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 14642 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.87
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.57
  • Minimum Established Patient Price $17.54
  • Maximum Established Patient Price $136.14
  • Average Established Patient Copayment $17.14
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.03

* 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 85.11, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 85.11 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 75.43

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 83.13

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 83.13

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Shiple is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE111 COLCHESTER AVE
BURLINGTON, VT 05401
(802) 847-0000Acute Care Hospitals

Reviews for DAVID A SHIPLE M.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.
1780828533
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271601621656
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 6 + 0 + 1 + 6 + 2 + 1 + 6 + 5 + 6 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1780828533 is valid because the calculated check digit 3 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
1821091950 LURA L DEVEAU ANP
Individual
Nurse Practitioner (Adult Health)601 ELMWOOD AVE BOX MED
ROCHESTER, NY 14642
(585) 275-7424
1245227776 DUNCAN D WORMER MD
Individual
Internal Medicine (Cardiovascular Disease)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-6168
1770569584 ELIZABETH A POWLEY NP
Individual
Nurse Practitioner (Family)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 273-3760
1407834310 LAURA ANN CUSHMAN PHD
Individual
Clinical Neuropsychologist601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-3271
1710940788 WARREN C HAMMERT MD
Individual
Plastic Surgery601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5117
1881651339DR. DEANNA LYNN GOHIL PHARM D
Individual
Pharmacist601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-1028
1851358303MR. NILESH UTTAMRAM GOHIL RPH
Individual
Pharmacist601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-1028
1538113816 SHIRLEY S MANDEVILLE FNP
Individual
Nurse Practitioner (Family)601 ELMWOOD AVE BOX SURG
ROCHESTER, NY 14642
(585) 276-3332
1487600490 KAY L RUST NP
Individual
Nurse Practitioner (Family)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1770539330 KRYSTOF JUNEK NEUMANN MD
Individual
Anesthesiology601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-2141
1023064565 ERDAL S ERTURK MD
Individual
Urology601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-3690
1972540151 CLELIA NEGRINI MD
Individual
Hospitalist601 ELMWOOD AVE BOX MED
ROCHESTER, NY 14642
(585) 275-3461
1952349458 DANIEL L TRIMBERGER II MD
Individual
Emergency Medicine601 ELMWOOD AVE BOX 655
ROCHESTER, NY 14642
(585) 341-3015
1104865278DR. JAMES DAUBERT MD
Individual
Internal Medicine (Cardiovascular Disease)601 ELMWOOD AVE BOX 679B
ROCHESTER, NY 14642
(585) 275-4751
1356380604 WILLIAM C HULBERT M.D.
Individual
Urology (Pediatric Urology)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1063451318 ROBERT S. DAVIS M.D.
Individual
Urology601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1053350314 MAUREEN E KIERNAN NP
Individual
Nurse Practitioner (Adult Health)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1457390726 CHERYL KLINE NP
Individual
Nurse Practitioner (Pediatrics)601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1174562441 JEANNE O'BRIEN MD
Individual
Urology601 ELMWOOD AVE
ROCHESTER, NY 14642
(585) 275-5282
1477592442DR. WINSTON E GAUM MD
Individual
Pediatrics (Pediatric Cardiology)601 ELMWOOD AVE BOX 635
ROCHESTER, NY 14642
(585) 275-7787

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780828533, enumerated in the NPI registry as an "individual" on April 23, 2009

The provider is located at 601 Elmwood Ave Box 659 Rochester, Ny 14642 and the phone number is (585) 273-3937

The provider's speciality is Ophthalmology with taxonomy code 207W00000X

The provider has more than 17 years of experience. He graduated from Ohio State University College Of Medicine in 2009.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. 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), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: coordinates care and seeks improvement of health outcomes.

Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $68.57 and an average copayment of 17.14. 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: Cataract surgery, Complex removal of cataract with insertion of prosthetic lens, Established patient complete exam of visual system, Established patient office or other outpatient visit, 30-39 minutes, Established patient problem focused exam of visual system, Exam of the internal drainage system of eye, Exam of visual field with extended testing, Imaging of optic nerve, Imaging of retina, Measurement of corneal curvature and depth of eye, New patient complete exam of visual system, New patient office or other outpatient visit, 45-59 minutes, Photography of the retina, Removal of cataract with insertion of prosthetic lens, Removal of recurring cataract in lens capsule using a laser and Ultrasound scan of cornea to determine thickness.

The practitioner is affiliated to the following hospital(s): UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 23, 2009. 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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