Individual provider Active NPI

Whitney Shaw, O.D.

  • Optometrist
  • Middleburg Heights, OH
National Provider Identifier
1356790414
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.6502 Issued in OH
Practice address
6835 Pearl Rd
Middleburg Heights, OH 44130-3616
Phone
(440) 884-4725
Fax
(440) 884-4752
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.6502 OH Primary

Addresses

Primary practice location

6835 Pearl Rd
Middleburg Heights, OH 44130-3616

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 464-1479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180306000798 OH Practitioner - Optometry 2567723604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clear Vision Solutions IncGroup PAC ID 1052797537, 3 clinicians

Practice addresses (Care Compare)

837 N Court St
Medina, OH 44256-1718
Phone (330) 312-0497

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.6502OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Vision Solutions, Inc. Optometrist CurrentSince Jan 10, 2024 Accepting new patients
SVS Vision Inc Optometrist PastSince Feb 26, 2018 Accepting new patients

Locations

837 N Court St
Medina, OH 44256
Phone (330) 312-0497

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1356790414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-464-1479",
            "fax_number": "586-464-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6835 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303616",
            "telephone_number": "440-884-4725",
            "fax_number": "440-884-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "WHITNEY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.6502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.