Individual provider Active NPI

Eric Noel Larsen, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1083793004
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
880426207 Issued in NV
Practice address
7324 W Cheyenne Ave
Suite 1
Las Vegas, NV 89129-7427
Phone
(702) 259-3937
Fax
(702) 645-6402
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 880426207 NV Primary

Addresses

Primary practice location

7324 W Cheyenne Ave
Suite 1
Las Vegas, NV 89129-7427

Mailing address

7324 W Cheyenne Ave
Suite 1
Las Vegas, NV 89129-7427
Phone (702) 259-3937

Other identifiers 4

IdentifierTypeStateIssuer
2502015MedicaidNV
5840350OtherNVAETNA
NV0223OtherNVNV LICENSE
05101OtherNVMES

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
I20051005001223 NV Practitioner - Optometry 5991720203 Practice locations: Las Vegas, NV

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7324 W Cheyenne Ave
Suite 1
Las Vegas, NV 89129-7426
Phone (702) 259-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Karl M. Larsen,O.D., LTD. Optometrist Past Accepting new patients
Herbert a. Starlin, O D a Nevada Professional Corporation PastSince Sep 30, 2017 Accepting new patients

Organizations & group practices 2

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1083793004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 W CHEYENNE AVE",
            "address_2": "SUITE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297427",
            "telephone_number": "702-259-3937",
            "fax_number": "702-645-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7324 W CHEYENNE AVE",
            "address_2": "SUITE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297427",
            "telephone_number": "702-259-3937",
            "fax_number": "702-645-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ERIC",
        "middle_name": "NOEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "880426207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502015",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5840350",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV LICENSE",
            "identifier": "NV0223",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MES",
            "identifier": "05101",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.