NPIMap

Organization Active NPI

Center for Advanced Eye Care, LLC

  • Ophthalmology Physician
  • Carson City, NV
National Provider Identifier
1013009307
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
31824 Issued in NV
Legal business name
CENTER FOR ADVANCED EYE CARE, LLC
Practice address
1104 North Division Street
Carson City, NV 89703-3803
Phone
(775) 882-9123
Fax
(775) 882-6030
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Mehdi Vazeen, M DNPI 1982600516
Title
Medical Director
Phone
(775) 882-9123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 31824 NV Primary

Addresses

Primary practice location

1104 North Division Street
Carson City, NV 89703-3803

Mailing address

1104 North Division Street
Carson City, NV 89703-3803
Phone (775) 882-9123

Other identifiers 3

IdentifierTypeStateIssuer
20-13063MedicaidNV
100502286MedicaidNV
100506942MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000467 NV Part B Supplier - Clinic/Group Practice 7315843851 Receives reassigned benefits from 5 practitioners
Practice locations: Carson City, NV; Minden, NV

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1516 Virginia Ranch Rd
Ste 2A
Gardnerville, NV 89410
Phone (775) 783-4823

1673 Lucerne St
Ste B
Minden, NV 89423
Phone (775) 782-5523

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1013009307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 NORTH DIVISION STREET",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033803",
            "telephone_number": "775-882-9123",
            "fax_number": "775-882-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 NORTH DIVISION STREET",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033803",
            "telephone_number": "775-882-9123",
            "fax_number": "775-882-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "VAZEEN",
        "authorized_official_first_name": "MEHDI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "775-882-9123",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "31824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-13063",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502286",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506942",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.