NPIMap

Organization Active NPI

Icare Las Vegas

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1174757231
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
557 Issued in NV
Legal business name
ICARE LAS VEGAS
Practice address
3300 E Flamingo Rd
#20
Las Vegas, NV 89121-4398
Phone
(702) 631-6125
NPI assigned
May 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Authorized official

Name
Dr. Gabriel Hernandez, O.D.NPI 1134103393
Title
President
Phone
(702) 631-6125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 557 NV Primary

Addresses

Primary practice location

3300 E Flamingo Rd
#20
Las Vegas, NV 89121-4398

Mailing address

2021 N Rainbow Blvd
Suite 100a
Las Vegas, NV 89108-7098
Phone (702) 631-6125

National Provider Directory

National Provider Directory
Tax ID family
Icare Las Vegas3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3300 E Flamingo Rd
Ste 20
Las Vegas, NV 89121
Phone (702) 434-9919

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1174757231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 N RAINBOW BLVD",
            "address_2": "SUITE 100A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891087098",
            "telephone_number": "702-631-6125",
            "fax_number": "702-636-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E FLAMINGO RD",
            "address_2": "#20",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214398",
            "telephone_number": "702-631-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE LAS VEGAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-631-6125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.