Individual provider Active NPI

Sara Yoo

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1649064346
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1267 Issued in NV
Practice address
4175 S Grand Canyon Dr Ste 105
Las Vegas, NV 89147-7155
Phone
(702) 912-4254
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1267 NV Primary

Addresses

Primary practice location

4175 S Grand Canyon Dr Ste 105
Las Vegas, NV 89147-7155

Mailing address

4175 S Grand Canyon Dr Ste 105
Las Vegas, NV 89147-7155
Phone (702) 912-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4175 S Grand Canyon Dr
Suite 105
Las Vegas, NV 89147-7155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyediology Vision Care Burke PLLC Optometrist CurrentSince Jul 28, 2026 Accepting new patients

Locations

4175 S Grand Canyon Dr
Ste 105
Las Vegas, NV 89147
Phone (702) 743-6100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1649064346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S GRAND CANYON DR STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477155",
            "telephone_number": "702-912-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S GRAND CANYON DR STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477155",
            "telephone_number": "702-912-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.