Individual provider Active NPI

Manpreet Rehal, O.D.

  • Optometrist
  • Reno, NV
National Provider Identifier
1295101244
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
936 Issued in NV
Practice address
3620 Mayberry Dr Ste 103
Reno, NV 89509-2131
Phone
(775) 525-3377
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 936 NV Primary

Addresses

Primary practice location

3620 Mayberry Dr Ste 103
Reno, NV 89509-2131

Mailing address

3620 Mayberry Dr Ste 103
Reno, NV 89509-2131
Phone (775) 525-3377

Other identifiers 1

IdentifierTypeStateIssuer
1295101244MedicaidNV

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
I20170915003198 NV Practitioner - Optometry 0840564795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Demers Family Vision Group, Inc.Group PAC ID 2860594488, 5 clinicians

Practice addresses (Care Compare)

4874 Sparks Blvd
Sparks, NV 89436-8206
Phone (775) 358-1317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Wong Optometry PC Optometrist Current Accepting new patients
Mayberry Vision, LLC Optometrist CurrentSince Jan 15, 2024 Accepting new patients
Demers Family Vision Group, Inc. Optometrist CurrentSince May 13, 2024 Accepting new patients
Erin Polukoshko, OD, PC Optometrist PastSince Jan 7, 2024 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

448 S Maine St
Fallon, NV 89406
Phone (775) 423-7411

9700 S McCarran Blvd
Reno, NV 89523
Phone (775) 746-8884

535 S Arlington Ave
Reno, NV 89509
Phone (775) 323-0157

3620 Mayberry Dr
Ste 103
Reno, NV 89509
Phone (775) 525-3377

10583 Double R Blvd
Reno, NV 89521
Phone (775) 323-4391

18601 Wedge Pkwy
Ste 2C
Reno, NV 89511
Phone (775) 358-1020

4874 Sparks Blvd
Sparks, NV 89436
Phone (775) 358-1317

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1295101244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 MAYBERRY DR STE 103",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895092131",
            "telephone_number": "775-525-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 MAYBERRY DR STE 103",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895092131",
            "telephone_number": "775-525-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHAL",
        "first_name": "MANPREET",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295101244",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.