Individual provider Active NPI

Civia Elizabeth McCaffrey, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1104935972
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
551 Issued in NV
Practice address
1700 N Buffalo Dr Ste 103
Las Vegas, NV 89128-2677
Phone
(702) 732-2020
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 551 NV Primary

Addresses

Primary practice location

1700 N Buffalo Dr Ste 103
Las Vegas, NV 89128-2677

Mailing address

2968 El Camino Rd
Las Vegas, NV 89146-5273
Phone (702) 355-9686

Other identifiers 1

IdentifierTypeStateIssuer
100510610MedicaidNV

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
I20070227000785 NV Practitioner - Optometry 3577562271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

900 S Pavilion Ctr Dr
Suite 140
Las Vegas, NV 89144-4583
Phone (702) 243-8788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
551NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Civia McCaffrey, OD, P.C. Optometrist CurrentSince Apr 19, 2019 Accepting new patients

Locations

900 S Pavilion Center Dr
Ste 140
Las Vegas, NV 89144
Phone (702) 243-8788

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1104935972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 EL CAMINO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465273",
            "telephone_number": "702-355-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N BUFFALO DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891282677",
            "telephone_number": "702-732-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFREY",
        "first_name": "CIVIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510610",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.