Individual provider Active NPI

Dara Lyn Shahon, M.D.

  • Ophthalmology Physician
  • Phoenix, AZ
National Provider Identifier
1649300211
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
19123 Issued in AZ
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 263-1200
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 19123 AZ Primary

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813010889 TX Practitioner - Ophthalmology 3476588351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dhew Ind HLTH SV HLTH SVS and MNTL HLTH AdmGroup PAC ID 1759290901, 219 clinicians

Practice addresses (Care Compare)

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19123AZMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Feb 4, 2017 Accepting new patients
DHHS IHS Phoenix CurrentSince Aug 1, 2016 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Feb 4, 2017 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

10005 E Osborn Rd
Scottsdale, AZ 85256
Phone (480) 362-7400

Organizations & group practices 4

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1649300211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHON",
        "first_name": "DARA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "19123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.