Phdra N Shaba, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1906 Issued in AZ

Practice address

16427 N Scottsdale Rd Ste 410
Scottsdale, AZ 85254-7102

Phone

(888) 495-4489

Fax

(602) 325-0169

NPI assigned

Jul 8, 2009

Last updated

Jun 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, NV, UT, TX4 enrollments

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 4

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Onesource Senior Healthcare PLLCGroup PAC ID 6901026988, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Onesource Senior Healthcare PLLC

  dba OneSource Mobile Healthcare PLLC

  • Podiatrist
  • Scottsdale, AZ
  • NPI 1508272188

  NV, TX, UT

  Medicare reassignment Care Compare group Authorized official
• Asap Health Solutions Inc

  • Internal Medicine Physician
  • Cave Creek, AZ
  • NPI 1295949014
  NPD (past)
• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  NPD (past)
• Cogent Healthcare of Arizona PC

  • Internal Medicine Physician
  • Sierra Vista, AZ
  • NPI 1568758266
  NPD (past)
• Geriatric Vision Care LLC

  • Ophthalmology Physician
  • Westmont, IL
  • NPI 1497830673

  Optometrist

  NPD (past)
• James M Noth M.D. , LTD

  • Specialist
  • Westmont, IL
  • NPI 1922219450
  NPD (past)
• Senior Eye Associates SC

  • Optometrist
  • Chicago, IL
  • NPI 1316088305
  NPD (past)
• Visionworks, Inc

  dba Visionworks

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD (past)
• Visionworks, Inc.

  dba Visionworks

  • Optometrist
  • Niles, IL
  • NPI 1831115906
  NPD (past)

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1689803926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "888-495-4489",
            "fax_number": "602-325-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16427 N SCOTTSDALE RD STE 410",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852547102",
            "telephone_number": "888-495-4489",
            "fax_number": "602-325-0169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N Rainbow Blvd Ste 300-307",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891071082",
            "country_code": "US",
            "telephone_number": "888-495-4489",
            "fax_number": "602-325-0169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABA",
        "first_name": "PHDRA",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "909",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "929136",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donal Sexton, M.D.
• Andrew Seymour
• Karly Kristine Sgambati, PT
• SH Operating LLC (Freedom Pain Hospital)
• Angela Shaba
• Edward Odeshoo Shabez, NMD
• Rick A Shacket, DO MD H
• Kayla Shackleton, PA
• Suzanne Shadix, ARNP
• Sylvia Darlene Shafer, PA C

• Optometrist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.