WHITNEY SHAW (O.D.) – Optometrist, NPI 1356790414

WHITNEY SHAW (O.D.) is a healthcare provider. based in Mount clemens, Michigan. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPT.6502 (OH). The NPI Number for WHITNEY SHAW (O.D.) is 1356790414

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
WHITNEY SHAW (O.D.)
NPI
1356790414
Phone
(586) 464-1479
Address
118 CASS AVE
Enumeration Date
9 June 2016
Last Update Date
21 February 2018

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
3303120497
Graduation Year
2016 (10 years ago)
PAC ID
2567723604
Group Practice PAC ID
1052797537
Professional Enrollment ID
I20180306000798
Address ID
OH442561718ME837XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,618 OPTOMETRY in OH

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Provider Addresses for WHITNEY SHAW (O.D.)

  • 118, Cass Avenue, Mount Clemens, Macomb County, Michigan, 48043, United States

    MOUNT CLEMENS, MI 480432204

    Phone: (586) 464-1479

    Fax: (586) 464-1480

    Type: Mailing

  • Pearl Road, Southland, Middleburg Heights, Cuyahoga County, Ohio, 44130, United States

    MIDDLEBURG HEIGHTS, OH 441303616

    Phone: (440) 884-4725

    Fax: (440) 884-4752

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $165.

Total Amount is formed as General ($165) + Research ($0) + Ownership ($0) = $165.

Last reported payment date: 2024-10-31 • Largest payer in this snapshot: CooperVision Inc. ($108).

Total Amount

$165

General + Research + Ownership

Payments

6

Total payment records

General Amount

$165

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-31

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-03-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180306000798IOptometryOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48043)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052797537View full group profile
NameSpecialtyState
O P T O M E T R YOH
O P T O M E T R YOH

Reviews

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Frequently asked questions

Does WHITNEY SHAW (O.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — WHITNEY SHAW (O.D.) uses 1356790414.
Can I rely on WHITNEY SHAW (O.D.) being an active provider?
As of the registry snapshot, WHITNEY SHAW (O.D.) is marked active.
What taxonomy line describes WHITNEY SHAW (O.D.)?
For research purposes, treat WHITNEY SHAW (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for WHITNEY SHAW (O.D.)?
WHITNEY SHAW (O.D.)'s geographic hint is Mount Clemens, Michigan in our summary view.
Why does WHITNEY SHAW (O.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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SVS VISION INC

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NPI: 1194879023
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NPI: 1811043938

SVS 01

Optometrist
118 CASS AVE
NPI: 1811032881

SVS VISION 03

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140 MACOMB PL
NPI: 1902941982

SVS VISION 2

Optometrist
118 CASS AVE
NPI: 1942345921