Individual provider Active NPI

Kyle Griffin, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1538771308
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1071 Issued in NV
Practice address
7090 N Durango Dr Ste 110
Las Vegas, NV 89149-4495
Phone
(702) 220-3937
Fax
(702) 655-3182
NPI assigned
Aug 21, 2020
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1071 NV Primary

Addresses

Primary practice location

7090 N Durango Dr Ste 110
Las Vegas, NV 89149-4495

Mailing address

7090 N Durango Dr Ste 110
Las Vegas, NV 89149-4495
Phone (702) 220-3937

Other practice location 1

4401 E Sunset Rd Ste 4
Henderson, NV 89014-2200
Phone (702) 299-6200

Other practice location 2

9650 W Skye Canyon Park Dr Ste 140
Las Vegas, NV 89166-6618
Phone (702) 803-2020

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
I20240418004325 NV Practitioner - Optometry 1052727328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Wang OD IncGroup PAC ID 9133163587, 3 clinicians

Practice addresses (Care Compare)

7090 N Durango Dr
Suite 110
Las Vegas, NV 89149-4495
Phone (702) 220-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1071NVMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Wang OD Inc Optometrist CurrentSince Feb 12, 2024 Accepting new patients

Locations

7090 N Durango Dr
Ste 110
Las Vegas, NV 89149
Phone (702) 220-3937

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, 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": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1538771308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 N DURANGO DR STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494495",
            "telephone_number": "702-220-3937",
            "fax_number": "702-655-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7090 N DURANGO DR STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494495",
            "telephone_number": "702-220-3937",
            "fax_number": "702-655-3182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 E Sunset Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890142200",
            "country_code": "US",
            "telephone_number": "702-299-6200",
            "fax_number": "702-655-3182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9650 W Skye Canyon Park Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891666618",
            "country_code": "US",
            "telephone_number": "702-803-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "KYLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.