| |
1 Breakthrough Way Las Vegas NV 89135-3011 | |
(702) 732-1493 | |
(702) 732-1080 |
Full Name | |
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Speciality | Pediatrics |
Location | 1 Breakthrough Way, Las Vegas, Nevada |
Authorized Official Name and Position | Christine Tonn (PRESIDENT) |
Authorized Official Contact | 7026915703 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10170 W Tropicana Ave # 156-252 Las Vegas NV 89147-8465 Ph: (702) 732-1493 | 1 Breakthrough Way Las Vegas NV 89135-3011 Ph: (702) 732-1493 |
NPI Number | 1013292689 |
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Provider Enumeration Date | 10/14/2011 |
Last Update Date | 11/14/2022 |
Certification Date | 11/14/2022 |
Medicare PECOS PAC ID | 9739303298 |
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Medicare Enrollment ID | O20140624001610 |
Identifier | Type | State | Issuer |
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1013292689 | NPI | - | NPPES |
Provider Name | David G Stewart |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1285602896 PECOS PAC ID: 9436128097 Enrollment ID: I20070503000107 |
Provider Name | Danielle T Bello |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1164434445 PECOS PAC ID: 4284897679 Enrollment ID: I20120522001265 |
Provider Name | Waseem S Alhushki |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1578740874 PECOS PAC ID: 8628294063 Enrollment ID: I20140722000037 |
Provider Name | Angela Berg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568845998 PECOS PAC ID: 6305148065 Enrollment ID: I20160112002139 |
Provider Name | Nicola Longo |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1275612749 PECOS PAC ID: 4183675937 Enrollment ID: I20160216001156 |
Provider Name | Joseph L Lasky |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1386680718 PECOS PAC ID: 8527075811 Enrollment ID: I20170612002830 |
Provider Name | Pamela H Kempert |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1124035266 PECOS PAC ID: 9830084110 Enrollment ID: I20200521003216 |
Provider Name | Suraj Pratap |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1114201704 PECOS PAC ID: 2466872056 Enrollment ID: I20201020004524 |
Provider Name | Sumit Gupta |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1548644883 PECOS PAC ID: 2365850450 Enrollment ID: I20210408001804 |
Provider Name | Aimee Foord |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1821312844 PECOS PAC ID: 1456641448 Enrollment ID: I20211115001953 |
Provider Name | Jessica Whitney Casey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174250013 PECOS PAC ID: 9739559154 Enrollment ID: I20221229002160 |
Provider Name | Raul Montiel-esparza |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1518315779 PECOS PAC ID: 9234595802 Enrollment ID: I20230524001824 |
Provider Name | Colleen Manzo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255857181 PECOS PAC ID: 6103190269 Enrollment ID: I20231120002879 |
Provider Name | Samantha Sherwood |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1528640653 PECOS PAC ID: 5890145072 Enrollment ID: I20231229002783 |
Provider Name | Jeanette Rebecca Rosenberg-line |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548986813 PECOS PAC ID: 3274076237 Enrollment ID: I20240618002941 |
Provider Name | Julie Bascones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740773183 PECOS PAC ID: 3274077680 Enrollment ID: I20240626003157 |
Provider Name | Elizabeth Robbins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497509913 PECOS PAC ID: 5193260826 Enrollment ID: I20240717002203 |
Provider Name | Saumya Joshi |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1558767806 PECOS PAC ID: 7113293044 Enrollment ID: I20240723002595 |
Provider Name | Dristhi Ragoonanan |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1831573005 PECOS PAC ID: 6901288406 Enrollment ID: I20240926001492 |
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