Individual provider Active NPI

Michael Gene Mayer, O.D.

  • Optometrist
  • Henderson, NV
National Provider Identifier
1043262025
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
499 Issued in NV
Practice address
62 N Pecos Rd Ste C
Henderson, NV 89074-7336
Phone
(702) 818-3100
NPI assigned
May 17, 2006
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 499 NV Primary

Addresses

Primary practice location

62 N Pecos Rd Ste C
Henderson, NV 89074-7336

Mailing address

62 N Pecos Rd Ste C
Henderson, NV 89074-7336
Phone (702) 818-3100

Other identifiers 1

IdentifierTypeStateIssuer
1043252025MedicaidNV

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
I20080104000117 NV Practitioner - Optometry 6002912953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1320 E Pebble Rd
Suite 100
Las Vegas, NV 89123-3113
Phone (702) 818-3100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
499NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faccinto and Mayer Eye Care P.C. Optometrist CurrentSince Oct 30, 2006 Accepting new patients

Locations

62 N Pecos Rd
Ste C
Henderson, NV 89074
Phone (702) 433-3355

1320 E Pebble Rd
Ste 100
Las Vegas, NV 89123
Phone (702) 616-1905

850 W Empire Mall
Sioux Falls, SD 57106
Phone (605) 361-4348

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1043262025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 N PECOS RD STE C",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747336",
            "telephone_number": "702-818-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 N PECOS RD STE C",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747336",
            "telephone_number": "702-818-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043252025",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.