Individual provider Active NPI

Emad R Shenouda, MD

  • Ophthalmology Physician
  • Des Moines, IA
National Provider Identifier
1336109545
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
33949 Issued in IA
Practice address
7011 Douglas Ave
Des Moines, IA 50322-3223
Phone
(515) 333-3333
Fax
(515) 362-7933
NPI assigned
Mar 23, 2006
Last updated
Nov 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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 33949 IA Primary

Addresses

Primary practice location

7011 Douglas Ave
Des Moines, IA 50322-3223

Mailing address

PO Box 7703
Des Moines, IA 50323-7703
Phone (515) 333-3333

Other identifiers 1

IdentifierTypeStateIssuer
1229203MedicaidIA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090109000465 IA Practitioner - Ophthalmology 2567525082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7011 Douglas Ave
Urbandale, IA 50322-3223
Phone (515) 333-3333

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33949IAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Christian Eye Clinic, PLC Ophthalmology CurrentSince Jun 21, 2001 Accepting new patients
The Christian Eye Clinic PLC Ophthalmology Current Accepting new patients

Locations

7011 Douglas Ave
Urbandale, IA 50322
Phone (515) 251-3700

Organizations & group practices 2

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1336109545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7703",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503237703",
            "telephone_number": "515-333-3333",
            "fax_number": "515-283-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503223223",
            "telephone_number": "515-333-3333",
            "fax_number": "515-362-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOUDA",
        "first_name": "EMAD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "33949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1229203",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.