Shelley Kaluf Dieudonne, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003192A Issued in IN

Practice address

980 Averitt Rd
Greenwood, IN 46143-9540

Phone

(317) 254-6480

Fax

(317) 259-8609

NPI assigned

Sep 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ovitsky Vision Care of Indiana PC

  • Optometrist
  • Indianapolis, IN
  • NPI 1831694330
  Medicare reassignment NPD

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1699960104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9795 CROSSPOINT BLVD",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563354",
            "telephone_number": "317-254-6480",
            "fax_number": "317-259-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 AVERITT RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439540",
            "telephone_number": "317-254-6480",
            "fax_number": "317-259-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEUDONNE",
        "first_name": "SHELLEY",
        "middle_name": "KALUF",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003192A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHM BC/BS",
            "identifier": "000000617702",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IN3192",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Jayne Dickson, DPT
• Benjamin John Diekhoff, DDS
• Edward John Diekhoff, MD
• Emily Diekhoff
• Sharon Dietzer, RBT
• Shelbi Diezel, PA
• Digimax Medical LLC
• Digimax Medical LLC
• Mark J Dilella, DO
• Ryan Scott Dill, M.D.

• Optometrist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.