Individual provider Active NPI

Brian S. Kawasaki, O.D., M.B.A.

  • Optometrist
  • North Las Vegas, NV
National Provider Identifier
1689630535
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
614 Issued in NV
Practice address
6900 North Pecos Road
VA Southern Nevada Healthcare System
North Las Vegas, NV 89086-4400
Phone
(702) 791-9125
Fax
(702) 791-9376
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11364 CA
Optometrist 152W00000X 614 NV Primary
Optometrist 152W00000X 2566 OK

Addresses

Primary practice location

6900 North Pecos Road
VA Southern Nevada Healthcare System
North Las Vegas, NV 89086-4400

Mailing address

6900 North Pecos Road
VA Southern Nevada Healthcare System
North Las Vegas, NV 89086-4400
Phone (702) 791-9125

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
614NVMDOptometrist
2566OKMDOptometrist
11364CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1689630535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 NORTH PECOS ROAD",
            "address_2": "VA SOUTHERN NEVADA HEALTHCARE SYSTEM",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9125",
            "fax_number": "702-791-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 NORTH PECOS ROAD",
            "address_2": "VA SOUTHERN NEVADA HEALTHCARE SYSTEM",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9125",
            "fax_number": "702-791-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWASAKI",
        "first_name": "BRIAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11364",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "614",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.