DR. SHANE FORD (O.D.) – Optometrist, NPI 1497714075

DR. SHANE FORD (O.D.) is a healthcare provider. based in Conway, Arkansas. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 2505 (AR). The NPI Number for DR. SHANE FORD (O.D.) is 1497714075

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANE FORD (O.D.)
NPI
1497714075
Phone
(501) 329-9851
Address
3005 FOUNTAIN DRIVE
Enumeration Date
21 March 2006
Last Update Date
18 October 2007

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
5013299851
Graduation Year
1995 (31 years ago)
PAC ID
8325017346
Group Practice PAC ID
3678529575
Professional Enrollment ID
I20040927001168
Address ID
AR720343684CO3005XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

422 OPTOMETRY in AR

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Provider Addresses for DR. SHANE FORD (O.D.)

  • 3005, Fountain Drive, Conway, Faulkner County, Arkansas, 72034, United States

    CONWAY, AR 720343684

    Phone: (501) 329-9851

    Fax: (501) 329-9854

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 38 Open Payments records for all available years, with a total value of $1,036.

Total Amount is formed as General ($1,036) + Research ($0) + Ownership ($0) = $1,036.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Alcon Vision LLC ($648).

Total Amount

$1,036

General + Research + Ownership

Payments

38

Total payment records

General Amount

$1,036

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-09-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040927001168IOptometryARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system269264$0
99213Established patient office or other outpatient visit, 20-29 minutes179131$0
92250Photography of the retina172157$0
92133Imaging of optic nerve8176$0
92134Imaging of retina7756$0
View full utilization report →

Insurance plans in this area (ZIP 72034)

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Provider's Procedures

DR. SHANE FORD (O.D.) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYAR92012Eye and medical examination for diagnosis and treatment, established patient114106
OPTOMETRYAR92083Measurement of field of vision during daylight conditions8982
OPTOMETRYAR92134Diagnostic imaging of retina5649

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678529575View full group profile
NameSpecialtyState
O P T O M E T R YAR
-AR
O P T O M E T R YAR
O P T O M E T R YAR
O P T O M E T R YAR
O P T O M E T R YAR
-AL

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. SHANE FORD (O.D.)?
DR. SHANE FORD (O.D.) — NPI 1497714075 — is the standard way to identify this listing.
Does the file indicate DR. SHANE FORD (O.D.) is practicing under active NPI?
Directory data currently reports DR. SHANE FORD (O.D.) as active.
What healthcare role does DR. SHANE FORD (O.D.) hold?
Scheduling teams often label DR. SHANE FORD (O.D.) under Optometrist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. SHANE FORD (O.D.)?
DR. SHANE FORD (O.D.)'s geographic hint is Conway, Arkansas in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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