REHABILITATION SPECIALIST OF HENDERSON INC – Physical Medicine & Rehabilitation Physician, NPI 1568404119
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for REHABILITATION SPECIALIST OF HENDERSON INC
1669, West Horizon Ridge Parkway, Macdonald Ranch, Henderson, Clark County, Nevada, 89012, United States
SUITE 100
HENDERSON, NV 890123516
Phone: (702) 386-1041
Fax: (702) 386-1042
Type: Mailing
9850 S MARYLAND PKWY STE A5 PMB 146
LAS VEGAS, NV 891837148
Phone: (702) 256-3637
Fax: (702) 386-1042
Type: Mailing
3022 S DURANGO DR STE 100
LAS VEGAS, NV 891174440
Phone: (702) 256-3637
Fax: (702) 386-1042
Type: Location
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-11-30 (920 days ago).
Enrollment records
1
Earliest due date
2023-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040713000310 | O | Clinic/Group Practice | NV | 2023-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 89012)
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