Eric T Brooker, O.D.
Individual provider Active NPI Optometrist · Las Vegas, NV
NPI 1386796969 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386796969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- NV439 (NV)
- Practice address
- 5269 S Eastern Ave
Las Vegas, NV 89119-2311 - Phone
- (702) 212-7755
- Fax
- (702) 795-0646
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern California College of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5269 S Eastern Ave
Las Vegas, NV 89119-2311
Phone (702) 212-7755
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050307000543 | NV | Practitioner - Optometry | 6709830300 | Practice locations: Las Vegas, NV |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NV439 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Eric T Brooker PC | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NV439 | NV | Yes |
Addresses
Primary practice location
5269 S Eastern Ave
Las Vegas, NV 89119-2311
Mailing address
5269 S Eastern Ave
Las Vegas, NV 89119-2311
Phone (702) 212-7755
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.