Individual provider Active NPI

Angela Hahn, O.D

  • Optometrist
  • Henderson, NV
National Provider Identifier
1417902677
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
394 Issued in NV
Practice address
310 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7099
Phone
(702) 550-2020
NPI assigned
May 24, 2006
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 394 NV Primary

Addresses

Primary practice location

310 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7099

Mailing address

310 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7099
Phone (702) 550-2020

Other identifiers 1

IdentifierTypeStateIssuer
100507722MedicaidNV

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
I20060220000125 NV Practitioner - Optometry 6709891302 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
394NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Jan 28, 2010 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Jan 28, 2010 Accepting new patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Jan 1, 2006 Accepting new patients
H Kenneth Kopolow O.D & Assoc P.C Optometrist Past Accepting new patients

Locations

1300 W Sunset Rd
Ste 1617
Henderson, NV 89014
Phone (702) 341-7254

75 S Valle Verde Dr
Ste 120
Henderson, NV 89012

3200 Las Vegas Blvd S
Ste 1620
Las Vegas, NV 89109
Phone (702) 341-7254

3614 S Maryland Pkwy
Las Vegas, NV 89169
Phone (702) 737-5243

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

8145 W Sahara Ave
Ste 510
Las Vegas, NV 89117
Phone (702) 360-0106

9975 S Eastern Ave
Ste 100
Las Vegas, NV 89183
Phone (702) 270-4636

Organizations & group practices 4

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1417902677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157099",
            "telephone_number": "702-550-2020",
            "fax_number": "702-665-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157099",
            "telephone_number": "702-550-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "ANGELA",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507722",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.