Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124982368 Individual Practitioner Male Practitioner

Dr. Samuel Jack Shroder , OD

Optometrist • Fairborn, OH

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Shroder, OD is a certified Optometrist practicing in Fairborn, OH. With approximately 1 years of clinical experience since graduating from Ohio State University - College Of Optometry in 2026, Dr. Shroder delivers high-quality medical care to the local community at 1790 COMMERCE CENTER BLVD.

Dr. Shroder does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1790 Commerce Center Blvd

Fairborn, OH 453246358

Telephone 9378783941
Associated Practice Facility / Clinic
🏢 Vision Center Ltd Facility NPI 1417034133

Medicare Profile & Education

Medical School

Ohio State University - College Of Optometry

Graduation Year

2026

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Fairborn, OH

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
Active -20.0 yrs vs City Avg
City Avg: 20.0 Yrs
State Avg: 23.4 Yrs
Regional Practice Density
4 Specialists

Practicing in Fairborn, OH (2535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-18
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OH OPT.007484

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1073666889

Doctor of Optometry

NPI 1104978196

Doctor of Optometry

NPI 1477605293

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2026

Optometrist (License #OPT.007484 in OH)

NPI Profile Active December 11, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location December 11, 2025

Registered at 1790 COMMERCE CENTER BLVD, FAIRBORN, OH 453246358 (Tel: 9378783941)

📍
Updated Business Mailing Address December 11, 2025

Registered at 1790 COMMERCE CENTER BLVD, FAIRBORN, OH 453246358 (Tel: 9378783941)

👤
Provider Name / Credentials Updated December 11, 2025

Recorded as SAMUEL SHRODER, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 11, 2025

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration December 11, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124982368
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 11, 2025
Last Update: May 18, 2026
Sole Proprietor: No

Mailing Address

1790 Commerce Center Blvd

Fairborn, OH 453246358

Phone: 9378783941

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.