Organization Active NPI

Nova Eyecare Center, LLC

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1205117975
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
206 Issued in AK
Legal business name
NOVA EYECARE CENTER, LLC
Practice address
2600 Denali St
Suite 603
Anchorage, AK 99503-2746
Phone
(907) 274-7825
Fax
(907) 274-7826
NPI assigned
Sep 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Dr. Nhan Thanh Tran, O.D.NPI 1649330978
Title
Owner/Optometrist
Phone
(907) 274-7825

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 206 AK Primary

Addresses

Primary practice location

2600 Denali St
Suite 603
Anchorage, AK 99503-2746

Mailing address

450 E Tudor Rd
Suite 200
Anchorage, AK 99503-7370
Phone (907) 274-7825

Other identifiers 1

IdentifierTypeStateIssuer
1577562MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000124 AK Part B Supplier - Clinic/Group Practice 8426225947 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

450 E Tudor Rd
Ste 200
Anchorage, AK 99503
Phone (907) 274-7825

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1205117975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E TUDOR RD",
            "address_2": "SUITE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037370",
            "telephone_number": "907-274-7825",
            "fax_number": "907-274-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DENALI ST",
            "address_2": "SUITE 603",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032746",
            "telephone_number": "907-274-7825",
            "fax_number": "907-274-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA EYECARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "NHAN",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "907-274-7825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1577562",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.