Individual provider Active NPI

Shaza Nizar Al-Holou, M.D.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • West Bloomfield, MI
National Provider Identifier
1689069882
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
4301501807 Issued in MI
Practice address
7001 Orchard Lake Rd Ste 200
West Bloomfield, MI 48322-3606
Phone
(248) 538-7400
Fax
(248) 538-7403
NPI assigned
Apr 3, 2015
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD466604 PA
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 4301501807 MI Primary

Addresses

Primary practice location

7001 Orchard Lake Rd Ste 200
West Bloomfield, MI 48322-3606

Mailing address

6689 Orchard Lake Rd # 297
West Bloomfield, MI 48322-3404
Phone (248) 254-8140

Other practice location 1

840 Walnut St Ste 1210
Philadelphia, PA 19107-5109
Phone (215) 928-3240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200729000074 MI Practitioner - Ophthalmology 4688988009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Eye Care PCGroup PAC ID 0244338127, 8 clinicians

Practice addresses (Care Compare)

7001 Orchard Lake Rd
Suite 200
West Bloomfield, MI 48322-3606
Phone (248) 538-7400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Eye Care PC Ophthalmology CurrentSince Sep 1, 2020 Accepting new patients
Children's Eye Care PC Ophthalmology CurrentSince Sep 1, 2020 Accepting new patients
Children's Eye Care, PC Ophthalmology Past Accepting new patients

Locations

42700 Garfield Rd
Ste 200
Clinton Twp, MI 48038
Phone (586) 532-3380

22731 Newman St
Ste 245
Dearborn, MI 48124
Phone (313) 561-1777

2355 Monroe St
Dearborn, MI 48124
Phone (313) 561-1777

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1689069882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD # 297",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404",
            "telephone_number": "248-254-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ORCHARD LAKE RD STE 200",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223606",
            "telephone_number": "248-538-7400",
            "fax_number": "248-538-7403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Walnut St Ste 1210",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075109",
            "country_code": "US",
            "telephone_number": "215-928-3240",
            "fax_number": "215-928-3983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-HOLOU",
        "first_name": "SHAZA",
        "middle_name": "NIZAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD466604",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "MI",
            "license": "4301501807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.