Charles Shidlofsky O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3987TG Issued in TX

Legal business name

CHARLES SHIDLOFSKY O.D., P.A.

Practice address

5934 W Parker Rd
Ste. 500
Plano, TX 75093-6409

Phone

(972) 312-0177

Fax

(972) 312-0134

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles Steven Shidlofsky, O.D.NPI 1134118177

Title

Owner

Phone

(972) 312-0177

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Shidlofsky, O.D.

  • Optometrist
  • Plano, TX
  • NPI 1134118177
  Medicare reassignment NPD Authorized official
• Jacqueline Ha Nguyen, OD

  • Optometrist
  • Pearland, TX
  • NPI 1023145497
  Medicare reassignment NPD
• Paul Kersjes, OD

  • Optometrist
  • Plano, TX
  • NPI 1538762182
  NPD
• Courtney Hazelwood Cates, OD

  • Optometrist
  • Dallas, TX
  • NPI 1851804587
  NPD (past)
• Kristen Hatton, OD

  • Optometrist
  • Plano, TX
  • NPI 1669033171
  NPD (past)
• Amir M Masoud, OD

  • Vision Therapy Optometrist
  • Plano, TX
  • NPI 1952231870
  NPD (past)
• Olivia Janine Browne

  • Optometrist
  • Forest Grove, OR
  • NPI 1467033621
  NPD (past)
• Gabrielle Magee, OD

  • Optometrist
  • Waukee, IA
  • NPI 1619698388
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1386833192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 W PARKER RD",
            "address_2": "STE. 500",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936409",
            "telephone_number": "972-312-0177",
            "fax_number": "972-312-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5934 W PARKER RD",
            "address_2": "STE. 500",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936409",
            "telephone_number": "972-312-0177",
            "fax_number": "972-312-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES SHIDLOFSKY O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "SHIDLOFSKY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-312-0177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3987TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "3987TG",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "3987TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "3987TG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "TX",
            "license": "3987TG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "3987TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Charles F. Natalizio MD
• Charlin Healthcare Services, Inc.
• Charlin Hospice LLC
• Chase Derrick MD PLLC
• Chase Kha Anesthesia Consultants MD PA
• Chase Oaks Chiropractic LLC

• Optometrist in Plano, TX
• Providers in Plano, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.