Shelby Alyse Anderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10025 Issued in TX

Practice address

5560 W Lovers LN Ste 240
Dallas, TX 75209-4287

Phone

(469) 775-9700

Fax

(806) 791-4077

NPI assigned

Jun 15, 2020

Last updated

Apr 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shelby Alyse Zak Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

95.14 of 100Reported as group

Quality

90.28

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment NPD
• Lamm David Eyecare

  • Optometrist
  • San Angelo, TX
  • NPI 1497024186
  NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Greenville, TX
  • NPI 1649800558
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1023633179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 W LOVERS LN STE 240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752094287",
            "telephone_number": "469-775-9700",
            "fax_number": "806-791-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHELBY",
        "middle_name": "ALYSE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "vcwtsouth@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3104 Indiana Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794103148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "ZAK",
            "middle_name": "ALYSE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Elizabeth Anderson, PT
• Sarah Anderson, PT
• Scott Richard Anderson, MD
• Shanta Anderson, PHARMD
• Shedrack Anderson
• Shelby Sutton Anderson, PHARMD
• Sherry Anderson
• Sophie Emma Anderson
• Sophie McCannon Anderson, FNP
• Stefany Oji Anderson, M.D.

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.