Active NPI
Icarelasvegas
- Optometrist
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 557
- Legal business name
- ICARELASVEGAS
- Practice address
- 6134 W Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659 - Phone
- (702) 631-4144
- Fax
- (702) 631-9094
- NPI assigned
- Jul 11, 2008
- Last updated
- Jun 13, 2012
- 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
- Dr. Gabriel Hernandez, O.D.
- Title
- Sole-Member
- Phone
- (702) 631-4144
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 557 | NV | Primary |
Addresses
Primary practice location
6134 W Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659
Mailing address
6134 W Lake Mead Blvd
E-8
Las Vegas, NV 89108-2659
Phone (702) 631-4144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH615A | Other | NV | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Icarelasvegas
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Las Vegas, NV
- NPI 1174757231
Locations
2021 N Rainbow Blvd
Ste 100A
Las Vegas, NV 89108
Phone (702) 631-6125
6134 W Lake Mead Blvd
#E8
Las Vegas, NV 89108
Phone (702) 220-4197
6134 W Lake Mead Blvd
Ste E8
Las Vegas, NV 89108
Phone (702) 631-4144
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
Practitioners 5
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.
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- Optometrist
- Las Vegas, NV
- NPI 1134103393
-
- Optometrist
- Las Vegas, NV
- NPI 1255818225
-
- Optometrist
- Las Vegas, NV
- NPI 1801980321
-
- Optometrist
- Las Vegas, NV
- NPI 1023007416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339545600000",
"number": "1366606139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6134 W LAKE MEAD BLVD",
"address_2": "E-8",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891082659",
"telephone_number": "702-631-4144",
"fax_number": "702-631-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6134 W LAKE MEAD BLVD",
"address_2": "E-8",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891082659",
"telephone_number": "702-631-4144",
"fax_number": "702-631-9094"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICARELASVEGAS",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-11",
"last_updated": "2012-06-13",
"status": "A",
"authorized_official_last_name": "HERNANDEZ",
"authorized_official_first_name": "GABRIEL",
"authorized_official_title_or_position": "SOLE-MEMBER",
"authorized_official_telephone_number": "702-631-4144",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "557",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "BH615A",
"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 Jun 13, 2012; 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.