NPIMap

Organization Active NPI

Optometric Care of Nevada, PC

Doing business as Eye Zone - Tahoe

  • Optometrist
  • Stateline, NV
National Provider Identifier
1104533108
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTOMETRIC CARE OF NEVADA, PC
Doing business as
Eye Zone - Tahoe
Practice address
276 Kingsbury Grade Ste 103
Stateline, NV 89449-9804
Phone
(775) 588-3500
NPI assigned
Oct 31, 2022
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Brittany Harrison
Title
Director
Phone
(916) 851-6611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

276 Kingsbury Grade Ste 103
Stateline, NV 89449-9804

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (704) 712-0564

Other names 1

  • Eye Zone - Tahoe Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200506001466 NV Part B Supplier - Clinic/Group Practice 7719318781 Receives reassigned benefits from 20 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV; Sparks, NV

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1104533108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "704-712-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 KINGSBURY GRADE STE 103",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894499804",
            "telephone_number": "775-588-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC CARE OF NEVADA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "916-851-6611"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Zone - Tahoe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stateline, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.