Organization Active NPI

David P Yesnick OD Prof Corp

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1083806970
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
335 Issued in NV
Legal business name
DAVID P YESNICK OD PROF CORP
Practice address
9191 W Flamingo Rd Ste 120
Las Vegas, NV 89147-6859
Phone
(702) 966-2020
Fax
(702) 966-2022
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Brenda Sanchez
Title
Billing
Phone
(702) 966-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 335 NV Primary

Addresses

Primary practice location

9191 W Flamingo Rd Ste 120
Las Vegas, NV 89147-6859

Mailing address

9191 W Flamingo Rd Ste 120
Las Vegas, NV 89147-6859
Phone (702) 966-2020

Other practice location 1

10198 W Flamingo Rd
Suite 100
Las Vegas, NV 89147-5730
Phone (702) 966-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000855 NV Part B Supplier - Clinic/Group Practice 0244209708 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

9191 W Flamingo Rd
Ste 120
Las Vegas, NV 89147
Phone (702) 476-0871

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1083806970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 W FLAMINGO RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476859",
            "telephone_number": "702-966-2020",
            "fax_number": "702-966-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 W FLAMINGO RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476859",
            "telephone_number": "702-966-2020",
            "fax_number": "702-966-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10198 W Flamingo Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891475730",
            "country_code": "US",
            "telephone_number": "702-966-2020",
            "fax_number": "702-966-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVID P YESNICK OD PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "702-966-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.