| Dignity Health Medical Group Nevada, Llc | |
|
10001 S Eastern Ave Suite 209 Henderson NV 89052-3907 | |
| (702) 616-5865 | |
| (702) 616-5828 |
| Full Name | Dignity Health Medical Group Nevada, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10001 S Eastern Ave, Henderson, Nevada |
| Authorized Official Name and Position | Melissa Walker (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7026165507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dignity Health Medical Group Nevada, Llc 2200 Paseo Verde Pkwy Ste 260 Henderson NV 89052-2703 Ph: (702) 616-5801 | Dignity Health Medical Group Nevada, Llc 10001 S Eastern Ave Suite 209 Henderson NV 89052-3907 Ph: (702) 616-5865 |
| NPI Number | 1376805416 |
|---|---|
| Provider Enumeration Date | 06/14/2012 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 1254571896 |
|---|---|
| Medicare Enrollment ID | O20130703000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376805416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carmelo V Rillera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467425421 PECOS PAC ID: 9133011687 Enrollment ID: I20040329000583 |
| Provider Name | Taposhi Swar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972769842 PECOS PAC ID: 7618960782 Enrollment ID: I20040405001469 |
| Provider Name | Heidi Ann Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700967304 PECOS PAC ID: 0547241820 Enrollment ID: I20040525000570 |
| Provider Name | Howard J Mason |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508964933 PECOS PAC ID: 9133105182 Enrollment ID: I20040629000751 |
| Provider Name | Michael G Wood |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1710014139 PECOS PAC ID: 2466431531 Enrollment ID: I20040714000697 |
| Provider Name | Neel Dhudshia |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1811975642 PECOS PAC ID: 3971575903 Enrollment ID: I20040810001307 |
| Provider Name | Raji Venkat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093712986 PECOS PAC ID: 1850360934 Enrollment ID: I20040927000178 |
| Provider Name | Angela R Shoho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295824142 PECOS PAC ID: 2567420219 Enrollment ID: I20041228000421 |
| Provider Name | Rama Harouni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093793697 PECOS PAC ID: 6305894734 Enrollment ID: I20050112000214 |
| Provider Name | Pauline E Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699731463 PECOS PAC ID: 0143267849 Enrollment ID: I20050414000171 |
| Provider Name | Catherine A Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457473001 PECOS PAC ID: 9537191374 Enrollment ID: I20050901000315 |
| Provider Name | Patrick Sychay Hong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902803521 PECOS PAC ID: 7618860685 Enrollment ID: I20050930000421 |
| Provider Name | Trent Thomas Richardson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013916261 PECOS PAC ID: 5597758730 Enrollment ID: I20060224000564 |
| Provider Name | Anant Kamalakar Sonpatki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407877343 PECOS PAC ID: 2567468606 Enrollment ID: I20061012000111 |
| Provider Name | Lisa Rosenberg |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1326013764 PECOS PAC ID: 3870497795 Enrollment ID: I20061019000531 |
| Provider Name | Mary B Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659450641 PECOS PAC ID: 0840299301 Enrollment ID: I20061211000175 |
| Provider Name | Paul T Emery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194798215 PECOS PAC ID: 2163520545 Enrollment ID: I20070608000049 |
| Provider Name | Kenneth Joseph Mooney |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396797973 PECOS PAC ID: 6800809898 Enrollment ID: I20070828000793 |
| Provider Name | Nidhi Mehta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982707774 PECOS PAC ID: 8820182207 Enrollment ID: I20070915000291 |
| Provider Name | Swati Wadhwani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588789846 PECOS PAC ID: 5092802660 Enrollment ID: I20071029000471 |
| Provider Name | Alan Greenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619955226 PECOS PAC ID: 6406936954 Enrollment ID: I20080109000553 |
| Provider Name | Seth K Adjovu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962407429 PECOS PAC ID: 4880684422 Enrollment ID: I20090716000154 |
| Provider Name | Cherubin Sumaway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467576934 PECOS PAC ID: 0840356093 Enrollment ID: I20090930000370 |
| Provider Name | Simi S Vancise |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841251469 PECOS PAC ID: 5698753044 Enrollment ID: I20100803000202 |
| Provider Name | Joseph W Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578513057 PECOS PAC ID: 6800080748 Enrollment ID: I20101104000451 |
| Provider Name | Inna Zdorovyak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437375433 PECOS PAC ID: 2062583297 Enrollment ID: I20110112000750 |
| Provider Name | Kurt Matthew Von Hartleben |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205809621 PECOS PAC ID: 9133304314 Enrollment ID: I20110503000752 |
| Provider Name | Elham Taherian |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1457476707 PECOS PAC ID: 8729121918 Enrollment ID: I20110817000709 |
| Provider Name | Nizar Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346546785 PECOS PAC ID: 8123298031 Enrollment ID: I20110901000628 |
| Provider Name | Trisha M Briones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205163359 PECOS PAC ID: 2668633785 Enrollment ID: I20120418000044 |
| Provider Name | Stefanie D Remson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083981955 PECOS PAC ID: 8325295561 Enrollment ID: I20120823000418 |
| Provider Name | Anoush H Tacvorian |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639300346 PECOS PAC ID: 3971753997 Enrollment ID: I20121026000499 |
| Provider Name | Rebecca T Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952653123 PECOS PAC ID: 4587819545 Enrollment ID: I20130225000365 |
| Provider Name | Zoya Qureshi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770828899 PECOS PAC ID: 0547409500 Enrollment ID: I20130624000261 |
| Provider Name | Celeste C Atkinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093823577 PECOS PAC ID: 1052554714 Enrollment ID: I20130827000969 |
| Provider Name | Olivia O Yuson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841487618 PECOS PAC ID: 0143455980 Enrollment ID: I20131101000356 |
| Provider Name | Mary Jo Stortz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285067629 PECOS PAC ID: 3476788985 Enrollment ID: I20131108000201 |
| Provider Name | Brian Chang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982925715 PECOS PAC ID: 0042446155 Enrollment ID: I20131120000613 |
| Provider Name | Nasibo H Kadir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104137546 PECOS PAC ID: 9739315649 Enrollment ID: I20131205001627 |
| Provider Name | Eric Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851557813 PECOS PAC ID: 7618016619 Enrollment ID: I20140113001570 |
| Provider Name | Theodore P Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760590210 PECOS PAC ID: 0648400259 Enrollment ID: I20140227000683 |
| Provider Name | Rowena Dela Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134555865 PECOS PAC ID: 2668604455 Enrollment ID: I20140409001813 |
| Provider Name | Jenifer Ausiello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588086250 PECOS PAC ID: 2062645450 Enrollment ID: I20140509001487 |
| Provider Name | Joseph E Dawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295052322 PECOS PAC ID: 4587888375 Enrollment ID: I20140618000359 |
| Provider Name | Christopher D Mercado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629377379 PECOS PAC ID: 3971736083 Enrollment ID: I20140805001321 |
| Provider Name | Mandy Yvonne Buttrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306070552 PECOS PAC ID: 2062669153 Enrollment ID: I20140815001091 |
| Provider Name | Orlando Felix Martinez Sosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508154477 PECOS PAC ID: 3173741758 Enrollment ID: I20140822001190 |
| Provider Name | Shirley Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043506744 PECOS PAC ID: 7416175427 Enrollment ID: I20140903001808 |
| Provider Name | Alexandra L Aguilar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336316421 PECOS PAC ID: 9739227810 Enrollment ID: I20141118002483 |
| Provider Name | Fema Aquino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134384779 PECOS PAC ID: 6709058092 Enrollment ID: I20141208000198 |
| Provider Name | Vishal S Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770793176 PECOS PAC ID: 0244379469 Enrollment ID: I20150106002084 |
| Provider Name | Julie L Carabajal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629327291 PECOS PAC ID: 3173848793 Enrollment ID: I20150202001564 |
| Provider Name | Wendy Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831590736 PECOS PAC ID: 2163748021 Enrollment ID: I20150312000033 |
| Provider Name | Jiji Ochoa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912390196 PECOS PAC ID: 2668786237 Enrollment ID: I20150728003725 |
| Provider Name | Karam Batieha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871857953 PECOS PAC ID: 1951623289 Enrollment ID: I20150901003377 |
| Provider Name | Deanna R St Cyr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609279629 PECOS PAC ID: 3577869619 Enrollment ID: I20160315002885 |
| Provider Name | Latricia Lacy-juste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073975090 PECOS PAC ID: 5698074904 Enrollment ID: I20160506001994 |
| Provider Name | David Berg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932441706 PECOS PAC ID: 5496077729 Enrollment ID: I20160616001801 |
| Provider Name | Jason G Zeizel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801134606 PECOS PAC ID: 3971895293 Enrollment ID: I20160707000789 |
| Provider Name | Jillian E Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184980179 PECOS PAC ID: 3577795079 Enrollment ID: I20160727001236 |
| Provider Name | Dodji V Modjinou |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710120068 PECOS PAC ID: 4981822905 Enrollment ID: I20161209001901 |
| Provider Name | Katrina J Mercado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801138573 PECOS PAC ID: 2163655275 Enrollment ID: I20170130000647 |
| Provider Name | Deepa D Kordick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396087094 PECOS PAC ID: 3173755873 Enrollment ID: I20170131001419 |
| Provider Name | Vernon Maniago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710420542 PECOS PAC ID: 3274801550 Enrollment ID: I20170608002317 |
| Provider Name | Suzanne H Elnagar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700311859 PECOS PAC ID: 0244501716 Enrollment ID: I20170801002579 |
| Provider Name | Jessica Malone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619263035 PECOS PAC ID: 8820394679 Enrollment ID: I20170925003579 |
| Provider Name | Dennis Cortez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720508658 PECOS PAC ID: 8820368954 Enrollment ID: I20171106001007 |
| Provider Name | Maria Carina Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124554472 PECOS PAC ID: 2860758802 Enrollment ID: I20171108001418 |
| Provider Name | Michelle Alicia Mark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083024194 PECOS PAC ID: 3971860677 Enrollment ID: I20171205003386 |
| Provider Name | Jeffery James Olsen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518301977 PECOS PAC ID: 2264743897 Enrollment ID: I20180129001204 |
| Provider Name | Brendon S Bicol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194147314 PECOS PAC ID: 4789945932 Enrollment ID: I20180302001495 |
| Provider Name | Florabelle C Miralles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467958256 PECOS PAC ID: 5193080745 Enrollment ID: I20180531001090 |
| Provider Name | Cordelia A Solomon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1326270547 PECOS PAC ID: 2769648161 Enrollment ID: I20180726002506 |
| Provider Name | Michael John Gale |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407290968 PECOS PAC ID: 1355695933 Enrollment ID: I20181117000442 |
| Provider Name | Wally Folad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326331893 PECOS PAC ID: 8022237841 Enrollment ID: I20190116003155 |
| Provider Name | Lindsay M Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760984207 PECOS PAC ID: 6608113469 Enrollment ID: I20190201000212 |
| Provider Name | Alyssa Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417434754 PECOS PAC ID: 4789924697 Enrollment ID: I20190312002727 |
| Provider Name | Bonnie Kwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891294732 PECOS PAC ID: 5193066546 Enrollment ID: I20190411001307 |
| Provider Name | Lee Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366917122 PECOS PAC ID: 8527303999 Enrollment ID: I20190510001368 |
| Provider Name | Disha Bharat Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326488651 PECOS PAC ID: 0547562951 Enrollment ID: I20190628001570 |
| Provider Name | Winner Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831509637 PECOS PAC ID: 1052638905 Enrollment ID: I20190709000683 |
| Provider Name | Susil Sivaraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437577327 PECOS PAC ID: 0840419982 Enrollment ID: I20190712000364 |
| Provider Name | Kevin Lee Downing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912419052 PECOS PAC ID: 4688909468 Enrollment ID: I20190716002834 |
| Provider Name | Danielle Planas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053762757 PECOS PAC ID: 2466730361 Enrollment ID: I20190807002294 |
| Provider Name | Steven Poertner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467834143 PECOS PAC ID: 1557678083 Enrollment ID: I20190823003066 |
| Provider Name | Faizan Sheraz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497117956 PECOS PAC ID: 5092009647 Enrollment ID: I20191016001164 |
| Provider Name | Sogol Sara Amjadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730636457 PECOS PAC ID: 2163754466 Enrollment ID: I20191105001722 |
| Provider Name | Donghyun Kim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548614563 PECOS PAC ID: 6305130592 Enrollment ID: I20191121001546 |
| Provider Name | Zhi Cheng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083076954 PECOS PAC ID: 0648565390 Enrollment ID: I20200102000030 |
| Provider Name | Joshua P Squiers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679774657 PECOS PAC ID: 7214064302 Enrollment ID: I20200401002116 |
| Provider Name | Morgan Michael Pomeranz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609294594 PECOS PAC ID: 5698094506 Enrollment ID: I20200717002433 |
| Provider Name | Nasim Amjadi Begvand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851740104 PECOS PAC ID: 8224452495 Enrollment ID: I20200721001974 |
| Provider Name | Sangouk Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386099703 PECOS PAC ID: 4284066168 Enrollment ID: I20200814001632 |
| Provider Name | Aishwarya Vyas Lahar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770005662 PECOS PAC ID: 9335407220 Enrollment ID: I20200814001887 |
| Provider Name | Jana Schade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912025362 PECOS PAC ID: 6406947910 Enrollment ID: I20200817001809 |
| Provider Name | Tuan B Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366633182 PECOS PAC ID: 8325195746 Enrollment ID: I20200913000008 |
| Provider Name | Sarah C Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427682061 PECOS PAC ID: 3870913643 Enrollment ID: I20201015002881 |
| Provider Name | Jason E Lao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437682333 PECOS PAC ID: 0749551679 Enrollment ID: I20201112003232 |
| Provider Name | Geoconda Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548860976 PECOS PAC ID: 6406269885 Enrollment ID: I20201231001436 |
| Provider Name | Robin Hass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629015193 PECOS PAC ID: 2769482736 Enrollment ID: I20210126001419 |
| Provider Name | Punam V Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952690042 PECOS PAC ID: 1254600489 Enrollment ID: I20210413001984 |
| Provider Name | Claire De Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669458956 PECOS PAC ID: 3274505102 Enrollment ID: I20210507000142 |
| Provider Name | Chan Park |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1932498722 PECOS PAC ID: 4486949401 Enrollment ID: I20210525000936 |
| Provider Name | Eliseo De Veyra Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740870070 PECOS PAC ID: 5698179141 Enrollment ID: I20210805003464 |
| Provider Name | Ann Roy-marrufo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700456621 PECOS PAC ID: 6709283203 Enrollment ID: I20210927001715 |
| Provider Name | Kimberly Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730166091 PECOS PAC ID: 9537062195 Enrollment ID: I20211027000329 |
| Provider Name | Irene Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831432137 PECOS PAC ID: 7113151648 Enrollment ID: I20211028002554 |
| Provider Name | Alan Walsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952789760 PECOS PAC ID: 6305130832 Enrollment ID: I20211214000815 |
| Provider Name | Paige Taylor Lewless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134709769 PECOS PAC ID: 9436540911 Enrollment ID: I20211216000851 |
| Provider Name | Jesse Alons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730851692 PECOS PAC ID: 4789077199 Enrollment ID: I20220208001174 |
| Provider Name | Craig Clifford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962909978 PECOS PAC ID: 4587098405 Enrollment ID: I20220210001928 |
| Provider Name | Crystal Chariee Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881299386 PECOS PAC ID: 9931592136 Enrollment ID: I20220211000320 |
| Provider Name | Karen S Myung |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679522437 PECOS PAC ID: 7810057841 Enrollment ID: I20220422000558 |
| Provider Name | Casey Marie Engel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568041960 PECOS PAC ID: 1850709577 Enrollment ID: I20220712002952 |
| Provider Name | Brooke Ersland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427325224 PECOS PAC ID: 9830333673 Enrollment ID: I20220713002325 |
| Provider Name | Sarah Kathrine Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851050140 PECOS PAC ID: 8426439217 Enrollment ID: I20220726001264 |
| Provider Name | Chadwycke Richard Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902387293 PECOS PAC ID: 7618219924 Enrollment ID: I20220804002064 |
| Provider Name | Jinn Patricia Calasara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649926874 PECOS PAC ID: 2668854738 Enrollment ID: I20220805001578 |
| Provider Name | Joel S Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972110922 PECOS PAC ID: 3779994199 Enrollment ID: I20220823003939 |
| Provider Name | Parker W Woody |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437512167 PECOS PAC ID: 8325300874 Enrollment ID: I20220906002165 |
| Provider Name | Julieta Sanchez-ruiz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1053792952 PECOS PAC ID: 6608288550 Enrollment ID: I20220915000685 |
| Provider Name | Curtis Lawrence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477856664 PECOS PAC ID: 9830334507 Enrollment ID: I20220930000281 |
| Provider Name | Syed Zubin Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336646249 PECOS PAC ID: 8628474863 Enrollment ID: I20221014002937 |
| Provider Name | Melissa Jarusiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689381998 PECOS PAC ID: 9032588462 Enrollment ID: I20221207001189 |
| Provider Name | Jancy Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083324057 PECOS PAC ID: 9335511500 Enrollment ID: I20230216001332 |
| Provider Name | Christopher T King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376084012 PECOS PAC ID: 7315287919 Enrollment ID: I20230310000618 |
| Provider Name | Ifesinachi Ndukwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619397536 PECOS PAC ID: 8820357064 Enrollment ID: I20230316002918 |
| Provider Name | Mihaela Missel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003378506 PECOS PAC ID: 6305175936 Enrollment ID: I20230328000305 |
| Provider Name | Mai Vi Ha Hoang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760745988 PECOS PAC ID: 3870735103 Enrollment ID: I20230329003168 |
| Provider Name | David Perkowski |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1942226279 PECOS PAC ID: 8022061449 Enrollment ID: I20230330000794 |
| Provider Name | Rahul Farwaha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346730520 PECOS PAC ID: 7214331982 Enrollment ID: I20230719003702 |
| Provider Name | Courtney M Saenz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376162057 PECOS PAC ID: 7810311610 Enrollment ID: I20230720004228 |
| Provider Name | Dylan Ryan Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104351402 PECOS PAC ID: 5193059459 Enrollment ID: I20230725000759 |
| Provider Name | Bruce M Toporoff |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1548263205 PECOS PAC ID: 1052416476 Enrollment ID: I20230803000861 |
| Provider Name | Joshua Fields |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487041802 PECOS PAC ID: 2961712302 Enrollment ID: I20230906003947 |
| Provider Name | Nidal Hamame |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649370867 PECOS PAC ID: 3870556863 Enrollment ID: I20231012001599 |
| Provider Name | Takema Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528670072 PECOS PAC ID: 3971958513 Enrollment ID: I20231017001517 |
| Provider Name | Carl Kevin Supnet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639791460 PECOS PAC ID: 1850747544 Enrollment ID: I20231101002054 |
| Provider Name | Carla E Cortez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821659178 PECOS PAC ID: 9032576186 Enrollment ID: I20231108001961 |
| Provider Name | Brandon W Carney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386037075 PECOS PAC ID: 0244515724 Enrollment ID: I20231227001767 |
| Provider Name | Eileen Cloonan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447448311 PECOS PAC ID: 9739276692 Enrollment ID: I20240109002931 |
| Provider Name | Ordessia Charran |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114345345 PECOS PAC ID: 0042556912 Enrollment ID: I20240307004216 |
| Provider Name | Hayley Rousek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588044770 PECOS PAC ID: 6901276492 Enrollment ID: I20240413000376 |
| Provider Name | Michael Moffatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669451936 PECOS PAC ID: 5294738670 Enrollment ID: I20240514000777 |
| Provider Name | Frank J Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881820579 PECOS PAC ID: 7719268960 Enrollment ID: I20240514003299 |
| Provider Name | Ansa George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083286769 PECOS PAC ID: 1456792787 Enrollment ID: I20240516003332 |
| Provider Name | Dennis Do |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740868686 PECOS PAC ID: 5799184784 Enrollment ID: I20240529002678 |
| Provider Name | Richard Ethan Tomlinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558894964 PECOS PAC ID: 5991118846 Enrollment ID: I20240611000437 |
| Provider Name | John Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104209550 PECOS PAC ID: 9830435593 Enrollment ID: I20240614003057 |
| Provider Name | Patricio Szajnowicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871262717 PECOS PAC ID: 4284170671 Enrollment ID: I20240722002398 |
| Provider Name | Harrison Fleming |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588190797 PECOS PAC ID: 9032443155 Enrollment ID: I20241119004441 |
| Provider Name | Ellean Zhang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962039677 PECOS PAC ID: 0042637639 Enrollment ID: I20241223001831 |
| Provider Name | Anaam F Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265922587 PECOS PAC ID: 8022463140 Enrollment ID: I20241226002099 |
| Provider Name | Yeabsra Aleligne |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770117186 PECOS PAC ID: 9335543586 Enrollment ID: I20250320002998 |
| Provider Name | Begum Sezer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891157939 PECOS PAC ID: 3173857844 Enrollment ID: I20250408003443 |
Victor Klausner, Do, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9005 S Pecos Rd, Ste 2610, Henderson, NV 89074 Phone: 702-474-0472 Fax: 702-474-4012 | |
Siena Hills Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2789 Sunridge Heights Pkwy, Suite 100, Henderson, NV 89052 Phone: 702-614-0850 Fax: 702-614-0798 | |
The Doc's Primary Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3005 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052 Phone: 702-997-7600 | |
Srinivas Vuthoori, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2610 W Horizon Ridge Pkwy, Suite #103, Henderson, NV 89052 Phone: 702-407-8241 Fax: 702-492-1728 | |
Mark Day, D.o., Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56 N Pecos Rd Ste A, Henderson, NV 89074 Phone: 702-456-9100 Fax: 702-434-7354 | |
Vitality Restored Chiropractic And Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1742 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89012 Phone: 725-735-6910 Fax: 725-735-6914 | |
Henderson Primary, Professional Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 880 Seven Hills Dr, Henderson, NV 89052 Phone: 702-482-2003 |