Prathibha Srikantan Wilson, OD, MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

1181 Issued in NV

Practice address

6230 N Durango Dr
Las Vegas, NV 89149-3916

Phone

(702) 737-3937

NPI assigned

Mar 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Miller and Miller, OD LTD

  • Optometrist
  • Las Vegas, NV
  • NPI 1487877064
  Medicare reassignment NPD

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1144978362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916",
            "telephone_number": "702-737-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PRATHIBHA",
        "middle_name": "SRIKANTAN",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nevin W Wilson, M.D.
• Nydia Wilson
• Omega Wilson
• Pamela Wilson
• Pamela Marie Wilson
• Raquel Massielle Wilson, CPC
• Reshard Wilson
• Rickie Wilson
• Rickie Wilson
• Robert Wilson

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.