| Prita Tandyasraya, MD | |
|
4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | |
| (702) 653-3244 | |
| (702) 653-2378 |
| Full Name | Prita Tandyasraya |
|---|---|
| Gender | Female |
| Speciality | Neurology |
| Experience | 8 Years |
| Location | 4700 Las Vegas Blvd N, Nellis Afb, Nevada |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144754979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME165558 (Florida) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | R76053 (Arizona) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Orlando | Orlando, FL | Hospital |
| Christus St Michael Health System | Texarkana, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nchmd Inc | 9436139565 | 444 |
| Virtual Neurology Texas Pllc | 3779910047 | 85 |
| Virtual Neurology Llc | 9830425321 | 102 |
| Entity Name | Nchmd Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831120195 PECOS PAC ID: 9436139565 Enrollment ID: O20040721000254 |
| Mailing Address | Practice Location Address |
|---|---|
| Prita Tandyasraya, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-3244 | Prita Tandyasraya, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-3244 |
Soukaina Noor, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
Dr. Ritesh Kool, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3880 | |
Michael R Hossack, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3802 | |
Dr. Jennifer Denise Lorenz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3880 Fax: 702-653-3883 | |
Dr. David Kvamme, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
Navdeep Dhaliwal, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 4700 Las Vegas Blvd N, Dept Of Neurology. Mike O'callaghan Federal Hospital, Nellis Afb, NV 89191 Phone: 702-653-3244 |