BETHEL HILLS CLINIC PLLC – Multi-Specialty Clinic/Center, NPI 1578104154

BETHEL HILLS CLINIC PLLC is a healthcare provider. based in Las vegas, Nevada. specializing in Multi-Specialty Clinic/Center. The NPI Number for BETHEL HILLS CLINIC PLLC is 1578104154

Main info

Organization
Name
BETHEL HILLS CLINIC PLLC
NPI
1578104154
Phone
(702) 530-4531
Address
1810 E Sahara Ave Ste 100
Authorized Official
OLUBUKOLA KOMOLAFE MEDICAL DIRECTOR
Enumeration Date
4 October 2019
Last Update Date
29 March 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:6State licenses:0Digital endpointsOther names

Provider Addresses for BETHEL HILLS CLINIC PLLC

  • 1810 E Sahara Ave Ste 100

    Las Vegas, NV 891043707

    Phone: (702) 530-4531

    Fax: (702) 660-7123

    Type: Location

  • 4446 E Des Moines

    Mesa, AZ 852058520

    Phone: (832) 542-3181

    Type: Location

  • 400 Union Ave SE Ste 200

    Olympia, WA 985012060

    Phone: (360) 394-6039

    Fax: (360) 394-6039

    Type: Location

  • 650 NE Holladay St Ste 1600

    Portland, OR 972322035

    Phone: (503) 766-6537

    Fax: (503) 766-6537

    Type: Location

  • PO BOX 2251

    SCOTTSDALE, AZ 852522251

    Phone:

    Type: Mailing

  • South 46th Place, Phoenix, Maricopa County, Arizona, 85044, United States

    PHOENIX, AZ 850447805

    Phone: (832) 542-3181

    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: 2022-04-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (12 days ago).

Enrollment records

3

Earliest due date

2026-05-31

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
O20200316002710OClinic/Group PracticeAZ2026-05-31
O20220311002312OClinic/Group PracticeORTBD
O20220406001864OClinic/Group PracticeWATBD

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.

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 89104)

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Reviews

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Frequently asked questions

What is the registry number for BETHEL HILLS CLINIC PLLC?
The registry entry for BETHEL HILLS CLINIC PLLC shows NPI 1578104154.
Quick check: is BETHEL HILLS CLINIC PLLC active?
Public NPPES data shows BETHEL HILLS CLINIC PLLC with an active NPI status right now.
What type of care does BETHEL HILLS CLINIC PLLC provide?
BETHEL HILLS CLINIC PLLC's profile centers on Multi-Specialty Clinic/Center. Clinical services aligned with this taxonomy classification.
Can patients visit BETHEL HILLS CLINIC PLLC in Las Vegas, Nevada?
For routing, start with Las Vegas, Nevada for BETHEL HILLS CLINIC PLLC, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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