Individual provider Active NPI

Lilian So, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1972129260
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1069 Issued in NV
Practice address
7361 W Lake Mead Blvd Ste 104
Las Vegas, NV 89128-1040
Phone
(702) 323-5404
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1069 NV Primary

Addresses

Primary practice location

7361 W Lake Mead Blvd Ste 104
Las Vegas, NV 89128-1040

Mailing address

7361 W Lake Mead Blvd Ste 104
Las Vegas, NV 89128-1040

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
I20200930001951 NV Practitioner - Optometry 9032534474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Girisgen and Kopolow OD PCGroup PAC ID 6507993854, 31 clinicians

Practice addresses (Care Compare)

7090 S Rainbow Blvd
Suite 100
Las Vegas, NV 89118-3288
Phone (702) 452-2020

75 Valle Verde Pkwy
Suite 120
Henderson, NV 89012
Phone (702) 452-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1069NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist Current Accepting new patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Aug 1, 2020 Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Dignity Health Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Kopolow & Girisgen Professional Corporation Optometrist Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Locations

1000 N Green Valley Pkwy
Ste 420
Henderson, NV 89074
Phone (725) 502-2802

1381 W Sunset Rd
Ste 120
Henderson, NV 89014

75 S Valle Verde Dr
Ste 120
Henderson, NV 89012

9460 W Flamingo Rd
Ste 100
Las Vegas, NV 89147

230 N Nellis Blvd
Ste B
Las Vegas, NV 89110
Phone (702) 360-8070

7090 S Rainbow Blvd
#100
Las Vegas, NV 89118

8025 S Rainbow Blvd
Ste 104
Las Vegas, NV 89139
Phone (702) 418-3118

3805 E Flamingo Rd
Ste 110
Las Vegas, NV 89121

8145 W Sahara Ave
Ste 510
Las Vegas, NV 89117
Phone (702) 360-0106

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

2021 N Rainbow Blvd
Ste 100
Las Vegas, NV 89108
Phone (702) 515-0200

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

9770 S Maryland Pkwy
Ste 10
Las Vegas, NV 89183
Phone (702) 492-0719

6160 W Tropicana Ave
Ste E4
Las Vegas, NV 89103

2279 N Rampart Blvd
Las Vegas, NV 89128
Phone (702) 341-0118

1820 E Lake Mead Blvd
Ste A-1
North Las Vegas, NV 89030
Phone (702) 891-9729

5465 Meadowood Mall Cir
Reno, NV 89502
Phone (775) 826-4100

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1972129260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7361 W LAKE MEAD BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7361 W LAKE MEAD BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281040",
            "telephone_number": "702-323-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "LILIAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.