Individual provider Active NPI

Dina Rasik Shah, O.D.

  • Vision Therapy Optometrist
  • Rolling Hills Estates, CA
National Provider Identifier
1386667806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
OPT12892 Issued in CA
Practice address
827 Deep Valley Dr
Ste 311
Rolling Hills Estates, CA 90274-3647
Phone
(310) 541-3411
Fax
(310) 541-6678
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X OPT12892 CA Primary

Addresses

Primary practice location

827 Deep Valley Dr
Ste 311
Rolling Hills Estates, CA 90274-3647

Mailing address

827 Deep Valley Dr
Ste 311
Rolling Hills Estates, CA 90274-3647
Phone (310) 541-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12892CAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Palos Verdes Family Vision PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386667806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 DEEP VALLEY DR",
            "address_2": "STE 311",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743647",
            "telephone_number": "310-541-3411",
            "fax_number": "310-541-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 DEEP VALLEY DR",
            "address_2": "STE 311",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743647",
            "telephone_number": "310-541-3411",
            "fax_number": "310-541-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DINA",
        "middle_name": "RASIK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "OPT12892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.