Bluetree Eyecare LLC
Organization Active NPI Optometrist · Sparks, NV
NPI 1386322758 · NPPES record last updated Dec 17, 2024
Key facts
- NPI
- 1386322758
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BLUETREE EYECARE LLC
- Practice address
- 2483 Wingfield Hills Rd Ste a-100
Sparks, NV 89436-7209 - Phone
- (775) 409-4614
- NPI assigned
- Jul 6, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Corom Eisley, OD
- Title
- Owner
- Phone
- (775) 446-7950
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241219002997 | NV | Part B Supplier - Clinic/Group Practice | 3870020530 |
Receives reassigned benefits from 1 practitioner Practice locations: Sparks, NV |
National Provider Directory
Locations
3605 Grant Dr
Reno, NV 89509
Phone (775) 770-3046
2483 Wingfield Hills Rd
Ste A100
Sparks, NV 89436
Phone (775) 409-4614
2483 Wingfield Hills Rd
#A100
Sparks, NV 89436
Phone (775) 446-7950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
2483 Wingfield Hills Rd Ste a-100
Sparks, NV 89436-7209
Mailing address
2483 Wingfield Hills Rd Ste a-100
Sparks, NV 89436-7209
Phone (775) 409-4614
Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.