Donald S. Mazzulla, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0231 Issued in NV

Practice address

4116 W Craig Rd
#104
North Las Vegas, NV 89032

Phone

(702) 631-2015

Fax

(702) 631-2511

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Desert Vision and Eye Care

  • Optometrist
  • N Las Vegas, NV
  • NPI 1184863557
  NPD (past) Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1194777219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8724 AZURE SKY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891292223",
            "telephone_number": "702-631-2015",
            "fax_number": "702-631-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 W CRAIG RD",
            "address_2": "#104",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-631-2015",
            "fax_number": "702-631-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZULLA",
        "first_name": "DONALD",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "0231",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "0231",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1194777219",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD231",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angrell D Mayeux
• Elodia Maynard
• Bryanna Carolyn Mayo
• Alejandra Jose Mayor Gonzalez
• Rosalba Mazariegos
• Shelia Mbohnyang
• Alonzo Damone McAllister
• Robert Dennis McAnelly, M.D.
• Melvin McBean, ORTHOPEDIC PA
• Brittney M McCadney, LCSW

• Optometrist in North Las Vegas, NV
• Providers in North 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 2, 2011; 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.