Individual provider Active NPI

Cynthia Kiernan, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1396825014
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
357 Issued in NV
Practice address
2310 E Serene Ave
Las Vegas, NV 89123-3248
Phone
(702) 614-5435
Fax
(702) 614-5426
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 357 NV Primary

Addresses

Primary practice location

2310 E Serene Ave
Las Vegas, NV 89123-3248

Mailing address

7732 Royal Oaks Rd
Las Vegas, NV 89123-2017
Phone (702) 614-5435

Other identifiers 1

IdentifierTypeStateIssuer
100507543MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000199 NV Practitioner - Optometry 7618002965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cynthia Kiernan OD IncGroup PAC ID 8729113998, 2 clinicians

Practice addresses (Care Compare)

2310 E Serene Ave
Las Vegas, NV 89123-3248
Phone (702) 614-5435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
357NVMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1396825014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 ROYAL OAKS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232017",
            "telephone_number": "702-614-5435",
            "fax_number": "702-614-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E SERENE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233248",
            "telephone_number": "702-614-5435",
            "fax_number": "702-614-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507543",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.