Maisha Optical LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAISHA OPTICAL LLC

Practice address

1251 E McAndrews Rd Ste 100
Medford, OR 97504-6497

Phone

(808) 264-4810

NPI assigned

Apr 11, 2023

Organization subpart

No

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

Authorized official

Name

Maisha LangellaNPI 1104116532

Title

Owner

Phone

(808) 677-7727

Specialties & licenses 2

Addresses

Other names 1

• Advanced Vision Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Locations

Practitioners 4

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

• Maisha Langella, O.D.

  • Optometrist
  • Grants Pass, OR
  • NPI 1104116532
  Medicare reassignment Care Compare group NPD Authorized official
• Gerald R Starchvick, O.D.

  • Corneal and Contact Management Optometrist
  • Medford, OR
  • NPI 1972508596
  Medicare reassignment Care Compare group NPD
• Nathan John Carling, OD

  • Optometrist
  • Medford, OR
  • NPI 1134046394
  NPD
• Matthew Scot Richardson, O.D.

  • Optometrist
  • Grants Pass, OR
  • NPI 1033211230
  NPD

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1013603380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 E MCANDREWS RD STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046497",
            "telephone_number": "808-264-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E MCANDREWS RD STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046497",
            "telephone_number": "808-264-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAISHA OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "LANGELLA",
        "authorized_official_first_name": "MAISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-677-7727"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vision Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Vision Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Maurice Mahan, M.D.
• Sulagshan Mahendrarajah, MD
• Jacob John Mahon, PHD; BCBA-D
• Jillian Lisa Marie Mahon, CADC-R, CRM
• Lexington Mainard, CRM
• Kathryn Maitas, M.A., LPC
• Amanda Rae Maitland
• Joan E Majeski
• Oana Denisa Majorant
• Shirley Ann Malcolm, DO

• Optometrist in Medford, OR
• Providers in Medford, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.