NPIMap

Organization Active NPI

Advanced Sierra Eyecare, Inc.

  • Optometrist
  • Carson City, NV
National Provider Identifier
1821216474
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
490 Issued in NV
Legal business name
ADVANCED SIERRA EYECARE, INC.
Practice address
3033 N Carson St
Carson City, NV 89706-0153
Phone
(775) 884-2020
Fax
(775) 234-5434
NPI assigned
Apr 20, 2007
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Dr. Benjamin Clark Seljestad, ODNPI 1124297148
Title
OD
Phone
(775) 884-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 490 NV Primary

Addresses

Primary practice location

3033 N Carson St
Carson City, NV 89706-0153

Mailing address

3450 Conte Dr
Carson City, NV 89701-4896
Phone (775) 884-2020

Other identifiers 2

IdentifierTypeStateIssuer
13805OtherNVSPECTERA
7944377OtherNVAETNA

Other names 1

  • Dr. Benjamin C. Seljestad Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040831000705 NV Part B Supplier - Clinic/Group Practice 7012982242 Receives reassigned benefits from 4 practitioners
Practice locations: Carson City, NV

National Provider Directory

National Provider Directory

Locations

700 Old Clear Creek Rd
Carson City, NV 89705
Phone (775) 881-2502

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1821216474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 CONTE DR",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897014896",
            "telephone_number": "775-884-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 N CARSON ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897060153",
            "telephone_number": "775-884-2020",
            "fax_number": "775-234-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SIERRA EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "SELJESTAD",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "775-884-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "13805",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7944377",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Benjamin C. Seljestad",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dr. Benjamin C. Seljestad",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.