Individual provider Active NPI

Susan Shahriari, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1760450423
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3846T Issued in TX
Practice address
4400 North Fwy # B
Suite 300
Houston, TX 77022-3604
Phone
(713) 697-2081
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3846T TX Primary
Optometrist 152W00000X 9419 CA

Addresses

Primary practice location

4400 North Fwy # B
Suite 300
Houston, TX 77022-3604

Mailing address

1829 Augusta Dr
Suite #8
Houston, TX 77057-3143

Other identifiers 1

IdentifierTypeStateIssuer
11616022OtherTXCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160720000253 CA Practitioner - Optometry 9234323551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44435 Town Ctr Way
Palm Desert, CA 92260-2711
Phone (443) 303-7517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Principle Optometry Group PC Optometrist CurrentSince Aug 30, 2018 Accepting new patients
Northline Tso PC Optometrist Past Accepting new patients
Northshore Tso, Inc. Optometrist Past Accepting new patients
Pasadena Optical Inc Optometrist PastSince Dec 11, 2013 Accepting new patients
Willowbrook Tso PC Optometrist PastSince Apr 9, 2014 Accepting new patients
PNZ Place Tso PC Optometrist Past Accepting new patients
Tomball Texas State Optical PA Optometrist PastSince Aug 1, 2016 Accepting new patients

Locations

44435 Town Center Way
Ste B
Palm Desert, CA 92260
Phone (443) 303-7517

Organizations & group practices 7

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1760450423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 AUGUSTA DR",
            "address_2": "SUITE #8",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 NORTH FWY # B",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770223604",
            "telephone_number": "713-697-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRIARI",
        "first_name": "SUSAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3846T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11616022",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.