Individual provider Active NPI

Robert Allen Pearson, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1023007416
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
232 Issued in NV
Practice address
6134 W. Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659
Phone
(702) 220-4197
Fax
(702) 220-4197
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 232 NV Primary
Optometrist 152W00000X 179T WY
Optometrist 152W00000X 8563 CA

Addresses

Primary practice location

6134 W. Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659

Mailing address

6134 W. Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659
Phone (702) 631-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20061109000631 NV Practitioner - Optometry 9739075961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8563CAMDOptometrist
179TWYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wonchon Lin, M.D., PLLC CurrentSince Jan 16, 2020 Accepting new patients
Optic Gallery Sahara LLC Optometrist CurrentSince Jan 16, 2020 Accepting new patients
Pearson Enterprises International LLC Optometrist CurrentSince Nov 1, 2007 Accepting new patients
Icarelasvegas Optometrist PastSince Aug 23, 2012 Accepting new patients

Locations

2580 S Decatur Blvd
Ste 6
Las Vegas, NV 89102
Phone (702) 570-2820

6134 W Lake Mead Blvd
#E8
Las Vegas, NV 89108
Phone (702) 220-4197

Interoperability endpoints

  • Direct secure messaging: robert.pearson@lvpt.directbygreenway.com

Organizations & group practices 4

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1023007416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6134 W. LAKE MEAD BLVD",
            "address_2": "E-8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082659",
            "telephone_number": "702-631-4144",
            "fax_number": "702-631-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 W. LAKE MEAD BLVD",
            "address_2": "E-8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082659",
            "telephone_number": "702-220-4197",
            "fax_number": "702-220-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "232",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "179T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.