Gammoh Premier Vision Llc is a medicare enrolled "Exclusive Provider Organization" provider in Las Vegas, Nevada. Their current practice location is
556 N Eastern Ave Ste A, Las Vegas, Nevada. You can reach out to their office (for appointments etc.) via phone at
(702) 388-9400.
Gammoh Premier Vision Llc is licensed to practice in Texas (license number 8041T) and it also participates in the medicare program. Gammoh Premier Vision Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1528304458.
Healthcare Provider's Profile
| Full Name | Gammoh Premier Vision Llc |
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| Type | Facility |
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| Speciality | Exclusive Provider Organization |
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| Location | 556 N Eastern Ave Ste A, Las Vegas, Nevada |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1528304458
- Provider Enumeration Date: 12/20/2012
- Last Update Date: 04/09/2018
Medicare PECOS Information:
- PECOS PAC ID: 4880849843
- Enrollment ID: O20130225000328
Medical Identifiers
Medical identifiers for Gammoh Premier Vision Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528304458 | NPI | - | NPPES |
| 345273201 | Medicaid | TX | |
| 1851668339 | Medicaid | NV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 716 (Nevada) | Secondary |
| 302F00000X | Exclusive Provider Organization | 8041T (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Gammoh Premier Vision Llc acts as a billing entity for following providers:
| Provider Name | Nataly Gammoh |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1851668339
PECOS PAC ID: 1254594054
Enrollment ID: I20130225000324 |
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| Provider Name | Lorenzo L Nichols |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1891135836
PECOS PAC ID: 2264662667
Enrollment ID: I20150601000311 |
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| Provider Name | Jeffrey C Natchez |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1609975085
PECOS PAC ID: 8325146681
Enrollment ID: I20211222000553 |
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| Provider Name | Sukumar Pandit |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1366487118
PECOS PAC ID: 1254344997
Enrollment ID: I20220103000328 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gammoh Premier Vision Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Gammoh Premier Vision Llc
556 N Eastern Ave Ste A,
Las Vegas, NV 89101-3453
Ph: (702) 388-9400 | Gammoh Premier Vision Llc
556 N Eastern Ave Ste A,
Las Vegas, NV 89101-3453
Ph: (702) 388-9400 |
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