Individual provider Active NPI

Philip Ronald Shands, M.D.

  • Ophthalmology Physician
  • Cleveland, OH
National Provider Identifier
1104929967
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35-051589 Issued in OH
Practice address
10701 East Blvd
Cleveland, OH 44106-1702
Phone
(216) 791-3800
Fax
(216) 229-2390
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35-051589 OH Primary

Addresses

Primary practice location

10701 East Blvd
Cleveland, OH 44106-1702

Mailing address

1001 Lakeside Ave E
#1200
Cleveland, OH 44114-1158

Other identifiers 1

IdentifierTypeStateIssuer
0906201MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000759 OH Practitioner - Ophthalmology 9032302302 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Health Services CurrentSince Jan 26, 2019 Accepting new patients
The Metrohealth System CurrentSince Mar 1, 2016 Accepting new patients
Circle Health Services CurrentSince Jan 26, 2019 Accepting new patients
The Metrohealth System CurrentSince Mar 1, 2016 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

12201 Euclid Ave
Cleveland, OH 44106
Phone (216) 373-2846

10 Severance Cir
Cleveland Heights, OH 44118
Phone (216) 297-2600

12301 Snow Rd
Parma Heights, OH 44130
Phone (216) 285-8810

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1104929967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVE E",
            "address_2": "#1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441141158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800",
            "fax_number": "216-229-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANDS",
        "first_name": "PHILIP",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-051589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0906201",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.