Simaan Shini, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

6652 TG Issued in TX

Practice address

1796 Graham Rd
College Station, TX 77845-9610

Phone

(979) 694-2000

Fax

(979) 694-2010

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

OptometryAlso: Ophthalmology

Education

University of Houston - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Shini OD PA

  • Optometrist
  • College Station, TX
  • NPI 1083862213
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093828436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 LONGMIRE DR STE K",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455281",
            "telephone_number": "979-694-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1796 GRAHAM RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778459610",
            "telephone_number": "979-694-2000",
            "fax_number": "979-694-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINI",
        "first_name": "SIMAAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6652TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "6652 TG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TX",
            "license": "6652 TG",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TX",
            "license": "6652 TG",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6652 TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6652 TG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "81343Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sheppard, LMT, BBCD, SBD
• Sherri J Brice OD PA
• Clint Stewart Sherrouse, FNP
• Monica Shields, RD
• Shini OD PA
• Amie Lynn Shird, LVN
• Yolanda Shivers, LVN
• Mimi M Sicilio, BS IN PT
• Melissa Silva
• Alden Lane Simmons, DPM

• Corneal and Contact Management Optometrist in College Station, TX
• Providers in College Station, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.