PriMMed Pain Institute – Pain Medicine (Anesthesiology) Physician, NPI 1902826464
Pain Medicine (Anesthesiology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PriMMed Pain Institute
5130 S FORT APACHE RD STE 215
LAS VEGAS, NV 891481732
Phone: (702) 798-0111
Fax: (866) 333-0436
Type: Mailing
321 N Pecos Rd Ste 200
Henderson, NV 890741348
Phone: (702) 798-0111
Fax: (866) 333-0436
Type: Location
6240 N Durango Dr Ste 110
Las Vegas, NV 891493943
Phone: (702) 798-0111
Fax: (866) 333-0436
Type: Location
2100 E Calvada Blvd
Pahrump, NV 890485805
Phone: (702) 798-0111
Fax: (866) 333-0436
Type: Location
801 S Rancho Dr Ste F4
Las Vegas, NV 891063814
Phone: (702) 798-0111
Fax: (866) 333-0436
Type: Location
5741 S FORT APACHE RD STE 120
LAS VEGAS, NV 891485622
Phone: (702) 798-0111
Fax: (844) 247-3481
Type: Mailing
South Fort Apache Road, Canyon Gate, Las Vegas, Clark County, Nevada, 89145-5800, United States
STE 215-232
LAS VEGAS, NV 891481719
Phone: (702) 798-0111
Fax: (844) 247-3481
Type: Mailing
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: 2018-02-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (616 days ago).
Enrollment records
2
Earliest due date
2024-09-30
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 |
|---|---|---|---|---|
| O20061006000619 | O | Clinic/Group Practice | NV | 2024-09-30 |
| O20180207000144 | O | Physician - Interventional Pain Management | NV | TBD |
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 89148)
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