SHAWNA MOINIPOUR (O.D.) – Optometrist, NPI 1447091657

SHAWNA MOINIPOUR (O.D.) is a healthcare provider. based in St augustine, Florida. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPC6454 (FL). The NPI Number for SHAWNA MOINIPOUR (O.D.) is 1447091657

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
SHAWNA MOINIPOUR (O.D.)
NPI
1447091657
Phone
(904) 287-9057
Address
161 HAMPTON POINT DR STE 3
Enumeration Date
3 June 2024
Last Update Date
23 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9048254525
Graduation Year
2024 (2 years ago)
PAC ID
1658813043
Group Practice PAC ID
6406990605
Professional Enrollment ID
I20240613001160
Address ID
FL320815097PO200XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

2,055 OPTOMETRY in FL

Provider Addresses for SHAWNA MOINIPOUR (O.D.)

  • 161 HAMPTON POINT DR STE 3

    ST AUGUSTINE, FL 320923058

    Phone: (904) 287-9057

    Type: Mailing

  • 8614 WESTWOOD CENTER DR FL 9

    VIENNA, VA 221822442

    Phone: (703) 847-8899

    Fax: (571) 223-6780

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $491.

Total Amount is formed as General ($491) + Research ($0) + Ownership ($0) = $491.

Last reported payment date: 2024-11-04 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($242).

Total Amount

$491

General + Research + Ownership

Payments

9

Total payment records

General Amount

$491

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-04

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: 2024-06-13

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
I20240613001160IOptometryFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32092)

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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: 6406990605View full group profile
NameSpecialtyState
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YNC
O P T O M E T R YVA
O P T O M E T R YVA
O P T O M E T R YIL

Reviews

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Frequently asked questions

Does SHAWNA MOINIPOUR (O.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SHAWNA MOINIPOUR (O.D.) uses 1447091657.
Is SHAWNA MOINIPOUR (O.D.) listed as active for patients and plans?
The listing shows SHAWNA MOINIPOUR (O.D.) as active in the NPI system.
What is SHAWNA MOINIPOUR (O.D.)'s primary classification?
Optometrist is the headline specialty for SHAWNA MOINIPOUR (O.D.) here. Clinical services aligned with this taxonomy classification.
Where is SHAWNA MOINIPOUR (O.D.) based?
SHAWNA MOINIPOUR (O.D.) is tied to St Augustine, Florida in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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