Optimumedicine LLC

Key facts

NPI

1578064002

Entity type

Organization (NPI type 2)

Primary specialty

Land Ambulance 3416L0300X

Legal business name

OPTIMUMEDICINE LLC

Practice address

175 E Reno Ave Ste C9
Las Vegas, NV 89119-1102

Phone

(844) 888-8911

Fax

(702) 435-7693

NPI assigned

Feb 21, 2018

Organization subpart

No

Authorized official

Name

Devon K. Eisma

Title

Ceo

Phone

(702) 286-6490

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Optimumedicine LLC Community Health Clinic/Center · Las Vegas, NV · NPI 1568105161
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Gannon, RN Flight Registered Nurse · Las Vegas, NV · NPI 1043138639
  NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in NV

Medicare enrollment records

National Provider Directory

Tax ID family

Optimumedicine (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 10, 2025.

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1578064002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93056",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891933056",
            "telephone_number": "844-888-8911",
            "fax_number": "702-435-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E RENO AVE STE C9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891191102",
            "telephone_number": "844-888-8911",
            "fax_number": "702-435-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUMEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "EISMA",
        "authorized_official_first_name": "DEVON",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-286-6490"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optimum Behavioral Care LLC
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• Optimum Medical Supply, Inc
• Optimumedicine LLC
• Option 1 Nutrition Solutions, LLC
• Option Care Enterprises, Inc
• Option Care Enterprises, Inc.
• Optometric Partnership LLC
• Optum Behavioral Care Therapy Services of Illinois PC

All providers in Las Vegas, NV · Land Ambulance in Nevada