Neil K Dickerson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

717 Issued in NV

Practice address

8660 W Cheyenne Ave Ste 120
Las Vegas, NV 89129-7455

Phone

(702) 790-2400

Fax

(702) 790-2441

NPI assigned

Aug 30, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Neil K Dickerson OD PLLC

  • Optometrist
  • Las Vegas, NV
  • NPI 1821758178
  Medicare reassignment Authorized official
• Karl M. Larsen,O.D., LTD.

  • Optometrist
  • Las Vegas, NV
  • NPI 1407159940
  NPD

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1588945901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8660 W CHEYENNE AVE STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297455",
            "telephone_number": "702-790-2400",
            "fax_number": "702-790-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8660 W CHEYENNE AVE STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297455",
            "telephone_number": "702-790-2400",
            "fax_number": "702-790-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "NEIL",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zena Dickens
• Bilal Dickerson Harris
• Amanda L. Dickerson, APRN
• Heidi Dickerson
• Marquelia Dickerson
• Shyndona Lynette Dickerson
• Tanika Dickerson
• William Dickerson
• Jean Dickey
• John Lee Dickey Jr.

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.