Individual provider Active NPI

Jeff Allen Villena, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1639741531
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1144 Issued in NV
Practice address
5556 S Fort Apache Rd
Las Vegas, NV 89148-7696
Phone
(702) 358-0472
Fax
(702) 425-9955
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 123594249934 UT
Optometrist 152W00000X 1144 NV Primary

Addresses

Primary practice location

5556 S Fort Apache Rd
Las Vegas, NV 89148-7696

Mailing address

5295 S Durango Dr Ste 102
Las Vegas, NV 89113-0188
Phone (702) 358-0472

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221121000464 NV Practitioner - Optometry 0547638785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Healthcare LLCGroup PAC ID 9638468739, 19 clinicians

Practice addresses (Care Compare)

2749 Sunridge Heights Pkwy
Henderson, NV 89052-5044
Phone (702) 358-0472

Merit-based Incentive Payment System (MIPS)

Final score
88.04 of 100Reported as group
Quality
86.9
Improvement activities
40
Cost
77.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123594249934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Meadows Healthcare LLC CurrentSince Sep 19, 2022 Accepting new patients

Locations

2749 Sunridge Heights Pkwy
Henderson, NV 89052
Phone (702) 568-0686

5295 S Durango Dr
Ste 102
Las Vegas, NV 89113

5556 S Fort Apache Rd
Las Vegas, NV 89148

5115 Camino Al Norte
North Las Vegas, NV 89031

2120 E Calvada Blvd
Pahrump, NV 89048
Phone (775) 727-8300

Organizations & group practices 1

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1639741531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5295 S DURANGO DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130188",
            "telephone_number": "702-358-0472",
            "fax_number": "702-425-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487696",
            "telephone_number": "702-358-0472",
            "fax_number": "702-425-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLENA",
        "first_name": "JEFF",
        "middle_name": "ALLEN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "123594249934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.