Optic Gallery Hualapai LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTIC GALLERY HUALAPAI LLC

Practice address

10170 W Tropicana Ave Ste 153
Las Vegas, NV 89147-8465

Phone

(702) 873-2121

NPI assigned

Feb 13, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth D Suh, ODNPI 1013324359

Title

Doctor/Owner

Phone

(702) 586-5222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 3

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

• Richard Eusebio, O.D

  • Optometrist
  • Las Vegas, NV
  • NPI 1427465608

  NV, Optometrist

  Medicare reassignment NPD
• Elizabeth Dong-Hee Suh, O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1013324359
  NPD Authorized official
• Laura Holt Maloney, O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1154467819
  NPD

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1346005998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 S FORT APACHE RD STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481716",
            "telephone_number": "702-586-5222",
            "fax_number": "702-586-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10170 W TROPICANA AVE STE 153",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478465",
            "telephone_number": "702-873-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC GALLERY HUALAPAI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "702-586-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optic Gallery Arroyo LLC
• Optic Gallery Blue Diamond Inc
• Optic Gallery Centennial Hills Inc.
• Optic Gallery Centennial Inc
• Optic Gallery DTS LLC
• Optic Gallery Nellis LLC
• Optic Gallery Sahara LLC
• Optic Gallery Skye Canyon LLC
• Optic Gallery Sohi LLC
• Optic Gallery Summerlin, Inc

• All providers in Las Vegas, NV
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.