Shannon L Heiss, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1366 Issued in NE

Practice address

3612 N 165TH St
Omaha, NE 68116-6459

Phone

(402) 916-9822

Fax

(402) 502-7776

NPI assigned

Jul 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Optometry

Education

Southern College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Definitive Vision LLCGroup PAC ID 4880870666, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Definitive Vision LLC

  • Optometrist
  • Omaha, NE
  • NPI 1215231717
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1578851341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 N 165TH ST STE 139",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166459",
            "telephone_number": "402-916-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 N 165TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166459",
            "telephone_number": "402-916-9822",
            "fax_number": "402-502-7776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3157 Farnam St Ste 7105",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681313553",
            "country_code": "US",
            "telephone_number": "402-502-7323",
            "fax_number": "402-502-7776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEISS",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tess Marie Heinzen
• Erica Heinzerling
• Nicholas Heiser, MD
• Jeremy Heisler
• Kami Rai Heiss, OTD, OTR/L
• Stacy K Heiss, M.S. CCC-SLP
• James M Heit, DDS
• Zachary Heit
• John Philip Heithoff
• Khalid Walid Hejazi

• Optometrist in Omaha, NE
• Providers in Omaha, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.