Optima Healthcare

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OPTIMA HEALTHCARE

Practice address

6859 S Eastern Ave Ste 103
Las Vegas, NV 89119-0003

Phone

(707) 236-2078

NPI assigned

Mar 7, 2024

Last updated

Mar 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marivic Banal

Title

Owner

Phone

(702) 236-2078

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krisel Anne Garcia Aquino

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1164297370
  Medicare reassignment

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1598523276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6859 S EASTERN AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 S EASTERN AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190003",
            "telephone_number": "707-236-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "BANAL",
        "authorized_official_first_name": "MARIVIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-236-2078"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optic Gallery Skye Canyon LLC (Optic Gallery)
• Optic Gallery Sohi LLC
• Optic Gallery Summerlin, Inc (Optic Gallery)
• Optic Gallery Tropicana LLC
• Optical Ophthamic Associates
• Optimal Balance Womens Care LLP
• Optimal Embrace LLC
• Optimal Mental Health Clinic
• Optimal TMS LLC
• Optimize Health LLC

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.