Organization Active NPI

Dry Eye Healing Institute

  • Optometrist
  • West Bloomfield, MI
National Provider Identifier
1124462452
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004524 Issued in MI
Legal business name
DRY EYE HEALING INSTITUTE
Practice address
5600 W Maple Rd Ste A120
West Bloomfield, MI 48322-3782
Phone
(248) 413-8030
NPI assigned
Apr 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Authorized official

Name
Jennifer Jane Shaba, ODNPI 1508095464
Title
Doctor
Phone
(248) 847-3372

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901004524 MI Primary

Addresses

Primary practice location

5600 W Maple Rd Ste A120
West Bloomfield, MI 48322-3782

Mailing address

5600 W Maple Rd Ste A120
West Bloomfield, MI 48322-3782
Phone (248) 847-3372

Other names 1

  • Dry Eye Healing Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130829000486 MI Part B Supplier - Clinic/Group Practice 3072756659 Receives reassigned benefits from 1 practitioner
Practice locations: West Bloomfield, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2243510Dry Eye Healing Institute5600 W Maple Road Suite a 120, West Bloomfield, MI 48322Certificate of waiverNov 18, 2027

National Provider Directory

National Provider Directory

Locations

29101 John R Rd
Madison Heights, MI 48071
Phone (248) 546-8076

27800 Novi Rd
Ste A
Novi, MI 48377
Phone (248) 380-3900

5600 W Maple Rd
Ste A120
West Bloomfield, MI 48322
Phone (248) 413-8030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1124462452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD STE A120",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223782",
            "telephone_number": "248-847-3372",
            "fax_number": "248-243-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD STE A120",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223782",
            "telephone_number": "248-413-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRY EYE HEALING INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "SHABA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-847-3372",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dry Eye Healing Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dry Eye Healing Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.