Diabetic Obesity Clinical Specialist is a medicare enrolled "Internal Medicine - Endocrinology, Diabetes & Metabolism" provider in Las Vegas, Nevada. Their current practice location is
7895 W Sunset Rd Ste 102, Las Vegas, Nevada. You can reach out to their office (for appointments etc.) via phone at
(702) 979-9910.
Diabetic Obesity Clinical Specialist is licensed to practice in NU (license number ) and it also participates in the medicare program. Diabetic Obesity Clinical Specialist
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 1396615514.
Healthcare Provider's Profile
| Full Name | Diabetic Obesity Clinical Specialist |
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| Type | Facility |
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| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
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| Location | 7895 W Sunset Rd Ste 102, 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. |
NPI Data:
- NPI Number: 1396615514
- Provider Enumeration Date: 11/11/2025
- Last Update Date: 11/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 9234610270
- Enrollment ID: O20260226003743
Medical Identifiers
Medical identifiers for Diabetic Obesity Clinical Specialist such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1396615514 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 111N00000X | Chiropractor | (NU) | Secondary |
| 133V00000X | Dietitian, Registered | (NU) | Secondary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (NU) | Primary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | (NU) | Secondary |
| 2080P0205X | Pediatrics - Pediatric Endocrinology | (NU) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (NU) | Secondary |
| 213E00000X | Podiatrist | (NU) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Diabetic Obesity Clinical Specialist acts as a billing entity for following providers:
| Provider Name | Michael D Russell |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1003012980 PECOS PAC ID: 2365535754 Enrollment ID: I20070830000187 |
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| Provider Name | Kenneth Fatkin |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1922238195 PECOS PAC ID: 6608064464 Enrollment ID: I20110107000320 |
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| Provider Name | Kevin P Ramsey |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1053591149 PECOS PAC ID: 5395882716 Enrollment ID: I20110701000106 |
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| Provider Name | Asheesh K Dewan |
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| Provider Type | Practitioner - Endocrinology |
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| Provider Identifiers | NPI Number: 1740352699 PECOS PAC ID: 5496648990 Enrollment ID: I20140630000496 |
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| Provider Name | Logan Smith |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1407372535 PECOS PAC ID: 2466880828 Enrollment ID: I20200317002590 |
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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. Diabetic Obesity Clinical Specialist 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 |
Diabetic Obesity Clinical Specialist 7895 W Sunset Rd Ste 102, Las Vegas, NV 89113-2275 Ph: (702) 979-9910 | Diabetic Obesity Clinical Specialist 7895 W Sunset Rd Ste 102, Las Vegas, NV 89113-2275 Ph: (702) 979-9910 |
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