| Greenstone Nevada Llc | |
|
2375 E Prater Way Fl 7 Sparks NV 89434-9641 | |
| (702) 453-3799 | |
| (702) 453-5741 |
| Full Name | Greenstone Nevada Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2375 E Prater Way Fl 7, Sparks, Nevada |
| Authorized Official Name and Position | Samuel Carli (PRESIDENT) |
| Authorized Official Contact | 7274244721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenstone Nevada Llc 10350 N Mccarran Blvd # 1037 Reno NV 89503-6848 Ph: (702) 453-3799 | Greenstone Nevada Llc 2375 E Prater Way Fl 7 Sparks NV 89434-9641 Ph: (702) 453-3799 |
| NPI Number | 1154943249 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 01/17/2023 |
| Medicare PECOS PAC ID | 5799108296 |
|---|---|
| Medicare Enrollment ID | O20200630002457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154943249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Joseph W. Heflin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447201447 PECOS PAC ID: 6406749381 Enrollment ID: I20140528001437 |
| Provider Name | Yi Zheng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497017784 PECOS PAC ID: 9638395502 Enrollment ID: I20150804005662 |
| Provider Name | Caleb Frink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619337573 PECOS PAC ID: 4981993821 Enrollment ID: I20160517001649 |
| Provider Name | Holly Fidelis Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326573684 PECOS PAC ID: 0648545913 Enrollment ID: I20171012001787 |
| Provider Name | Samuel Carli |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275821076 PECOS PAC ID: 2668691759 Enrollment ID: I20180615002375 |
| Provider Name | Jaskarin Kaur |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114311677 PECOS PAC ID: 6204143613 Enrollment ID: I20180808003025 |
| Provider Name | Munadel A Awad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821529058 PECOS PAC ID: 1557635547 Enrollment ID: I20200724002609 |
| Provider Name | Jing He |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023541745 PECOS PAC ID: 4082031273 Enrollment ID: I20200902002429 |
| Provider Name | Yanning Wang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124551817 PECOS PAC ID: 9032537030 Enrollment ID: I20200908001513 |
| Provider Name | Irtqa Ilyas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396249124 PECOS PAC ID: 6406108505 Enrollment ID: I20210727003880 |
| Provider Name | Lisa Santana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760156194 PECOS PAC ID: 3870999550 Enrollment ID: I20210903000837 |
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