Principle Optometry Group PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PRINCIPLE OPTOMETRY GROUP PC

Practice address

44435 Town Center Way
Suite B
Palm Desert, CA 92260

Phone

(760) 674-7272

NPI assigned

Sep 1, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Susan Shahriari, ODNPI 1760450423

Title

Owner/Optometrist

Phone

(281) 414-4685

Specialties & licenses 1

Addresses

Other names 1

• MODERN ICARE OPTOMETRY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Susan Shahriari, O.D.

  • Optometrist
  • Houston, TX
  • NPI 1760450423

  CA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1649752072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 E AVENIDA PALMERA",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92264",
            "telephone_number": "281-414-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44435 TOWN CENTER WAY",
            "address_2": "SUITE B",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "92260",
            "telephone_number": "760-674-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCIPLE OPTOMETRY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-01",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "SHAHRIARI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "281-414-4685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODERN ICARE OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.