Organization Active NPI

Hills & Dales Vision Inc

  • Optometrist
  • Canton, OH
National Provider Identifier
1356547889
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T3044 Issued in OH
Legal business name
HILLS & DALES VISION INC
Practice address
4555 Hills and Dales Rd NW
Canton, OH 44708-1507
Phone
(330) 478-8996
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Dr. Kaleel Shaheen, O.D.
Title
Optometrist
Phone
(330) 478-8996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T3044 OH Primary

Addresses

Primary practice location

4555 Hills and Dales Rd NW
Canton, OH 44708-1507

Mailing address

4555 Hills and Dales Rd NW
Canton, OH 44708-1507

Other identifiers 1

IdentifierTypeStateIssuer
0197675MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100805000494 OH Part B Supplier - Clinic/Group Practice 6709919178 Receives reassigned benefits from 4 practitioners
Practice locations: Canton, OH
O20100930065365 OH DME Supplier - Physician - Optometrist 6709919178 Practice locations: Canton, OH

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hills and Dales Vision, Inc.4555 Hills and Dales Rd NW, Canton, OH 44708-1507(330) 478-8996 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1356547889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081507",
            "telephone_number": "330-478-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLS & DALES VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "SHAHEEN",
        "authorized_official_first_name": "KALEEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "330-478-8996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T3044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0197675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.