Active NPI
Roger Paez O.D. Chartered
- Optometrist
- Las Vegas, NV
National Provider Identifier
1306034855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 507
- Legal business name
- ROGER PAEZ O.D. CHARTERED
- Practice address
- 5905 S Eastern Ave Ste 101
Las Vegas, NV 89119-3130 - Phone
- (702) 893-3937
- Fax
- (702) 893-3429
- NPI assigned
- Oct 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Johnson
- Title
- President
- Phone
- (702) 893-3937
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 507 | NV | Primary |
Addresses
Primary practice location
5905 S Eastern Ave Ste 101
Las Vegas, NV 89119-3130
Mailing address
5905 S Eastern Ave Ste 101
Las Vegas, NV 89119-3130
Phone (702) 893-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100506828 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4131 S Eastern Ave
Ste 300
Las Vegas, NV 89119
Phone (702) 893-3937
5905 S Eastern Ave
Ste 101
Las Vegas, NV 89119
Phone (702) 893-3937
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Las Vegas, NV
- NPI 1467023168
-
- Optometrist
- Henderson, NV
- NPI 1083044333
-
- Optometrist
- Las Vegas, NV
- NPI 1720334832
-
- Optometrist
- Las Vegas, NV
- NPI 1568878163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1533859200000",
"number": "1306034855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5905 S EASTERN AVE STE 101",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891193130",
"telephone_number": "702-893-3937",
"fax_number": "702-893-3429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 S EASTERN AVE STE 101",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891193130",
"telephone_number": "702-893-3937",
"fax_number": "702-893-3429"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROGER PAEZ O.D. CHARTERED",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-10",
"last_updated": "2018-08-10",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "702-893-3937"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "NV",
"license": "507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100506828",
"state": "NV"
}
],
"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 Aug 10, 2018; 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.