Organization Active NPI

Prosthetics Advancement Lab, LLC

  • Ocularist
  • Las Vegas, NV
National Provider Identifier
1972002632
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Legal business name
PROSTHETICS ADVANCEMENT LAB, LLC
Practice address
3199 E Warm Springs Rd Ste 300
Las Vegas, NV 89120-3150
Phone
(702) 207-9500
Fax
(702) 852-0492
NPI assigned
Feb 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Authorized official

Name
Janet C Chao, BCO, CCANPI 1285081331
Title
Managing Member
Phone
(702) 207-9500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OcularistGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1700X Primary
AnaplastologistGroup: 193200000X MULTI-SPECIALTY GROUP 229N00000X

Addresses

Primary practice location

3199 E Warm Springs Rd Ste 300
Las Vegas, NV 89120-3150

Mailing address

3199 E Warm Springs Rd Ste 300
Las Vegas, NV 89120-3150
Phone (702) 207-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181023001306 NV DME Supplier - Ocularist 5991058893 Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Prosthetics Advancement Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3663 E Sunset Rd
Ste 506
Las Vegas, NV 89120
Phone (702) 609-9203

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1972002632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3199 E WARM SPRINGS RD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203150",
            "telephone_number": "702-207-9500",
            "fax_number": "702-852-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3199 E WARM SPRINGS RD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203150",
            "telephone_number": "702-207-9500",
            "fax_number": "702-852-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETICS ADVANCEMENT LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "CHAO",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-207-9500",
        "authorized_official_credential": "BCO, CCA"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "229N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anaplastologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.