Individual provider Active NPI

Diana Chang

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1629422985
Registry record updated Jan 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
933 Issued in NV
Practice address
10870 W Charleston Blvd Ste 105
Las Vegas, NV 89135-1159
Phone
(702) 877-3937
NPI assigned
Apr 22, 2016
Last updated
Jan 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 933 NV Primary

Addresses

Primary practice location

10870 W Charleston Blvd Ste 105
Las Vegas, NV 89135-1159

Mailing address

10870 W Charleston Blvd Ste 105
Las Vegas, NV 89135-1159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170918000155 NV Practitioner - Optometry 6406120377 Reassigns benefits to 1 organization
I20240220002298 NM Practitioner - Optometry 6406120377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
933NVMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Chang OD LLC Optometrist Current Accepting new patients
Pritchett Eye Care PC Optometrist Current Accepting new patients
Visionworks, Inc CurrentSince Feb 20, 2024 Accepting new patients
Pritchett Eye Care PC Optometrist CurrentSince Sep 15, 2017 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Feb 20, 2024 Accepting new patients
Pritchett Eye Care PC Optometrist CurrentSince Sep 15, 2017 Accepting new patients

Locations

700 S Telshor Blvd
Ste 1536
Las Cruces, NM 88011
Phone (575) 522-8244

10870 W Charleston Blvd
Ste 105
Las Vegas, NV 89135
Phone (702) 877-3937

7335 S Pecos Rd
Las Vegas, NV 89120
Phone (702) 451-1522

1601 E Basin Ave
Ste 101
Pahrump, NV 89060
Phone (775) 751-1791

5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436
Phone (775) 359-2020

Organizations & group practices 6

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1629422985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10870 W CHARLESTON BLVD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 W CHARLESTON BLVD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351159",
            "telephone_number": "702-877-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.