Individual provider Active NPI

Garrett Arizala, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1104970607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
298 Issued in NV
Practice address
1910 E Serene Ave
Las Vegas, NV 89123-3227
Phone
(702) 307-0828
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 298 NV Primary

Addresses

Primary practice location

1910 E Serene Ave
Las Vegas, NV 89123-3227

Mailing address

3717 Julius CT
Las Vegas, NV 89129-5519
Phone (702) 307-0828

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
I20091105000262 NV Practitioner - Optometry 9537207972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1910 E Serene Ave
Suite 1
Las Vegas, NV 89123-3218
Phone (702) 307-0828

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298NVMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Garrett H. Arizala, O.D., Prof. Corp. Optometrist CurrentSince Aug 18, 2009 Accepting new patients

Locations

1910 E Serene Ave
Las Vegas, NV 89123
Phone (702) 307-0828

1910 E Serene Ave
Ste 1
Las Vegas, NV 89123
Phone (702) 307-0828

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104970607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 JULIUS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295519",
            "telephone_number": "702-307-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E SERENE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233227",
            "telephone_number": "702-307-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIZALA",
        "first_name": "GARRETT",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.