Unknown Individual – Nephrology Physician, NPI 1508856519

Unknown Individual is a healthcare provider. based in Las vegas, Nevada. specializing in Nephrology Physician. They hold a License No. 3359 (NV). The NPI Number for Unknown Individual is 1508856519

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508856519
Phone
(702) 877-1887
Address
500 S RANCHO DR
Deactivation Date
11 February 2021

Doctor Profile

Medical School Name
CHICAGO COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
7028771887
Graduation Year
1964 (62 years ago)
PAC ID
5193852903
Group Practice PAC ID
2961499322
Professional Enrollment ID
I20100428000310
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 500, South Rancho Drive, Rancho Circle, Las Vegas, Clark County, Nevada, 89106, United States

    SUITE 12

    LAS VEGAS, NV 891064844

    Phone: (702) 877-1887

    Fax: (702) 877-4536

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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 89106)

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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: 2961499322View full group profile
NameSpecialtyState
-NV
Family PracticeNV
Nurse PractitionerNV
-NV
Nurse PractitionerNV
Nurse PractitionerNV
Nurse PractitionerNV
-NV
Nephrology, Internal MedicineNV
Nurse PractitionerNV

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1508856519 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Nephrology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Las Vegas, Nevada for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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