Diana Chang
Individual provider Active NPI Optometrist · Las Vegas, NV
NPI 1629422985 · NPPES record last updated Jan 1, 2018
Key facts
- NPI
- 1629422985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 933 (NV)
- Practice address
- 10870 W Charleston Blvd Ste 105
Las Vegas, NV 89135-1159 - Phone
- (702) 877-3937
- NPI assigned
- Apr 22, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170918000155 | NV | Practitioner - Optometry | 6406120377 | Reassigns benefits to 1 organization |
| I20240220002298 | NM | Practitioner - Optometry | 6406120377 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 933 | NV | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pritchett Eye Care PC | Optometrist | Current |
Accepting new patients |
| Pritchett Eye Care PC | Optometrist | Current |
Accepting new patients |
| Pritchett Eye Care PC | Optometrist | Current | Accepting new patients |
| Visionworks, Inc. | Optometrist | Current |
Accepting new patients |
| Diana Chang OD LLC | Optometrist | Current | Accepting new patients |
| Visionworks, Inc | Current |
Accepting new patients |
Locations
700 S Telshor Blvd
Ste 1536
Las Cruces, NM 88011
Phone (575) 522-8244
7335 S Pecos Rd
Las Vegas, NV 89120
Phone (702) 451-1522
10870 W Charleston Blvd
Ste 105
Las Vegas, NV 89135
Phone (702) 877-3937
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 933 | NV | Yes |
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
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.