Individual provider Active NPI

Lisa Marie Guerrero, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1417141243
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
588 Issued in NV
Practice address
1300 S Eastern Ave
Las Vegas, NV 89104-3902
Phone
(702) 385-2242
NPI assigned
Sep 5, 2007
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 588 NV Primary

Addresses

Primary practice location

1300 S Eastern Ave
Las Vegas, NV 89104-3902

Mailing address

5562 Fairmeade Way
Las Vegas, NV 89135-4039

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
I20141016001480 NV Practitioner - Optometry 0749360774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7955 Blue Diamond Rd
Suite 105
Las Vegas, NV 89178-9300
Phone (702) 270-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
588NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Family Eye Care, Todd C. Angell, O.D. LTD Optometrist CurrentSince Jul 19, 2014 Accepting new patients
Moderneyes Family Eye Care Magdato Guerrero PLLC Optometrist CurrentSince Dec 29, 2017 Accepting new patients
Summerlin Vision Center Inc Optometrist PastSince Nov 16, 2015 Accepting new patients

Locations

1300 S Eastern Ave
Las Vegas, NV 89104
Phone (702) 385-2242

7955 Blue Diamond Rd
Ste 105
Las Vegas, NV 89178
Phone (702) 270-9000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1417141243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 FAIRMEADE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891354039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043902",
            "telephone_number": "702-385-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.