Individual provider Active NPI

Shahrokh Dayyani, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1194893008
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T10307 Issued in CA
Practice address
2635 S Robertson Blvd
Los Angeles, CA 90034-2401
Phone
(310) 319-6122
Fax
(626) 421-7966
NPI assigned
Nov 30, 2006
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T10307 CA Primary
Corneal and Contact Management Optometrist 152WC0802X T10307 CA
Low Vision Rehabilitation Optometrist 152WL0500X T10307 CA
Pediatric Optometrist 152WP0200X T10307 CA

Addresses

Primary practice location

2635 S Robertson Blvd
Los Angeles, CA 90034-2401

Mailing address

2635 S Robertson Blvd
Los Angeles, CA 90034-2401
Phone (310) 319-6122

Other identifiers 1

IdentifierTypeStateIssuer
GSD001450MedicaidCA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120807000717 CA Practitioner - Optometry 8921254939 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Runway Optometry a Professional Optometric CorpGroup PAC ID 1759795651, 3 clinicians
Modo Optometry a Professional Optometry CorpGroup PAC ID 1850775529, 3 clinicians

Practice addresses (Care Compare)

12751 Millennium
Suite 130
Los Angeles, CA 90094-2978
Phone (310) 582-5501

2635 S Robertson Blvd
Los Angeles, CA 90034-2401
Phone (310) 319-6122

4718 /4 Admiralty Way
Marina del Rey, CA 90292-6905
Phone (310) 200-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T10307CAMDCorneal and Contact Management Optometrist
10307CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr S Dayyani OD a Prof Corp Optometrist CurrentSince Nov 9, 2011 Accepting new patients
Modo Optometry a Professional Optometry Corp Optometrist CurrentSince Jul 21, 2022 Accepting new patients
Dan Rod Optometric Center Inc Optometrist CurrentSince Feb 5, 2024 Accepting new patients
Runway Optometry a Professional Optometric Corp. Optometrist CurrentSince Jan 31, 2022 Accepting new patients
Modo Optometry Optometrist Past Accepting new patients

Locations

2635 S Robertson Blvd
Los Angeles, CA 90034
Phone (310) 319-6122

4718 Admiralty Way
Marina del Rey, CA 90292

4718 Admiralty Way
#34
Marina del Rey, CA 90292
Phone (310) 200-4222

12751 Millennium
Ste 130
Playa Vista, CA 90094
Phone (310) 582-5501

322 Wilshire Blvd
Santa Monica, CA 90401
Phone (310) 319-6122

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1194893008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342401",
            "telephone_number": "310-319-6122",
            "fax_number": "626-421-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342401",
            "telephone_number": "310-319-6122",
            "fax_number": "626-421-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYYANI",
        "first_name": "SHAHROKH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "T10307",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "T10307",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "T10307",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "T10307",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD001450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.