JUSTINE IBANEZ IPAC (PA-C) – Physician Assistant, NPI 1306417647

JUSTINE IBANEZ IPAC (PA-C) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for JUSTINE IBANEZ IPAC (PA-C) is 1306417647

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
JUSTINE IBANEZ IPAC (PA-C)
NPI
1306417647
Phone
(702) 420-2163
Address
2701 N TENAYA WAY STE 290
Enumeration Date
7 July 2021
Last Update Date
23 April 2024

Doctor Profile

Medical School Name
UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Secondary Phone
7024202163
Graduation Year
2022 (4 years ago)
PAC ID
7012351901
Group Practice PAC ID
0648492181
Professional Enrollment ID
I20240219003567
Address ID
NV891281406LA2701XWAYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:4State licenses:0Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for JUSTINE IBANEZ IPAC (PA-C)

  • 2701 N TENAYA WAY STE 290

    LAS VEGAS, NV 891281406

    Phone: (702) 420-2163

    Fax: (702) 420-2930

    Type: Mailing

  • 1851 STEAMBOAT PKWY UNIT 2704

    RENO, NV 895216344

    Phone: (702) 215-1627

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 302 Open Payments records for all available years, with a total value of $8,112.

Total Amount is formed as General ($8,112) + Research ($0) + Ownership ($0) = $8,112.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($1,808).

Total Amount

$8,112

General + Research + Ownership

Payments

302

Total payment records

General Amount

$8,112

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240219003567IPhysician AssistantNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648492181View full group profile
NameSpecialtyState
Physician AssistantFL
-NV
Physician AssistantNV
D E R M A T O L O G YNV

Reviews

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Frequently asked questions

What unique ID ties claims to JUSTINE IBANEZ IPAC (PA-C)?
NPI 1306417647 is assigned to JUSTINE IBANEZ IPAC (PA-C) under the national enumeration system.
Is JUSTINE IBANEZ IPAC (PA-C) currently active in the NPI registry?
CMS-published data lists JUSTINE IBANEZ IPAC (PA-C) as an active registrant.
What kind of provider is JUSTINE IBANEZ IPAC (PA-C)?
The page reflects Physician Assistant for JUSTINE IBANEZ IPAC (PA-C). Clinical services aligned with this taxonomy classification.
Where does public data place JUSTINE IBANEZ IPAC (PA-C)?
The snapshot lists Las Vegas, Nevada for JUSTINE IBANEZ IPAC (PA-C); download NPPES for the complete set.
Is JUSTINE IBANEZ IPAC (PA-C) a real provider?
This page reflects official NPPES data for NPI 1306417647. Always confirm identity and privileges with the practice and licensing boards.

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