Unknown Individual – Physician Assistant, NPI 1972521730
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1358, Paseo Verde Parkway, Henderson, Clark County, Nevada, 89012, United States
SUITE #110
HENDERSON, NV 890125724
Phone: (702) 982-7100
Fax: (702) 982-7102
Type: Location
1022, Boulder City Parkway, Boulder City, Clark County, Nevada, 89005, United States
# 184
BOULDER CITY, NV 890051825
Phone: (702) 982-7100
Fax: (702) 982-7102
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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.
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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 89012)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NV | |
| Nurse Practitioner | NV | |
| Nurse Practitioner | NV | |
| Physician Assistant | NV | |
| Physician Assistant | NV | |
| P S Y C H I A T R Y | NV | |
| Interventional Pain Management, Internal Medicine | NV | |
| Nurse Practitioner | NV | |
| Interventional Pain Management, Internal Medicine | NV | |
| - | NV |
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