Optic Gallery Skye Canyon LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTIC GALLERY SKYE CANYON LLC

Practice address

9560 W Skye Canyon Park Dr Ste 180
Las Vegas, NV 89166-6795

Phone

(702) 872-2020

Fax

(702) 443-9022

NPI assigned

Mar 8, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Erin Frillarte, ODNPI 1417212481

Title

Partner/Optometrist

Phone

(702) 336-9349

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Optic Gallery Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

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

• Erin Frillarte, O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1417212481
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710028800000",
    "number": "1043078561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 ORCHARD HARVEST AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314819",
            "telephone_number": "702-336-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9560 W SKYE CANYON PARK DR STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666795",
            "telephone_number": "702-872-2020",
            "fax_number": "702-443-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC GALLERY SKYE CANYON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A",
        "authorized_official_last_name": "FRILLARTE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PARTNER/OPTOMETRIST",
        "authorized_official_telephone_number": "702-336-9349",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "V106621",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optic Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Optic Gallery Centennial Inc
• Optic Gallery DTS LLC
• Optic Gallery Hualapai LLC
• Optic Gallery Nellis LLC
• Optic Gallery Sahara LLC
• Optic Gallery Sohi LLC
• Optic Gallery Summerlin, Inc
• Optic Gallery Tropicana LLC
• Optical Ophthamic Associates
• Optima Healthcare

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2024; 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.