Active NPI
Jose Camerino Magana Perez
- Optician
- Henderson, NV
National Provider Identifier
1104605997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 619
- Practice address
- 540 Marks St
Henderson, NV 89014-6654 - Phone
- (702) 547-6678
- Fax
- (702) 547-6874
- NPI assigned
- Sep 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 619 | NV | Primary |
Addresses
Primary practice location
540 Marks St
Henderson, NV 89014-6654
Mailing address
540 Marks St
Henderson, NV 89014-6654
Phone (702) 547-6678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 619 | NV | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1104605997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 MARKS ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890146654",
"telephone_number": "702-547-6678",
"fax_number": "702-547-6874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 MARKS ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890146654",
"telephone_number": "702-547-6678",
"fax_number": "702-547-6874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGANA PEREZ",
"first_name": "JOSE",
"middle_name": "CAMERINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NV",
"license": "619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.