Individual provider Active NPI

Haleh Shams, O.D.

  • Optometrist
  • Altamonte Springs, FL
National Provider Identifier
1639371438
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4086 Issued in FL
Practice address
112 Marcia Dr
Altamonte Springs, FL 32714-2913
Phone
(407) 337-6306
Fax
(076) 372-0754
NPI assigned
Jun 4, 2007
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4086 FL Primary

Addresses

Primary practice location

112 Marcia Dr
Altamonte Springs, FL 32714-2913

Mailing address

112 Marcia Dr
Altamonte Springs, FL 32714-2913
Phone (407) 337-6306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051031000369 FL Practitioner - Optometry 8426075326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4086FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
You and Eyecare, LLC Optometrist CurrentSince Aug 2, 2023 Accepting new patients
Florida Eye Clinic P a Optometrist Past Accepting new patients

Locations

112 Marcia Dr
Altamonte Springs, FL 32714
Phone (407) 337-6306

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, 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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1639371438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MARCIA DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142913",
            "telephone_number": "407-337-6306",
            "fax_number": "407-637-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MARCIA DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142913",
            "telephone_number": "407-337-6306",
            "fax_number": "076-372-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMS",
        "first_name": "HALEH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.