MEDICARE: ALDER NEVADA OCULOPLASTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1174320923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALDER NEVADA OCULOPLASTICS PLLC

Provider Business Mailing Address
First Line	:	2850 W HORIZON RIDGE PKWY STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7305 S PECOS RD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3701
Country	:	US
Telephone Number	:	702-485-5000
Fax Number	:	702-485-5001

Authorized Official
Title or Position	:	SENIOR CREDENTIALING MANAGER
Name	:	MS. SINEI MIKUS
Credential	:
Telephone Number	:	702-577-0665

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	04/06/2026

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