| Santa Rosa Medical Centers Of Nevada, Inc. | |
|
4161 S Eastern Ave Suite B3 Las Vegas NV 89119-5484 | |
| (702) 693-6222 | |
| (702) 369-6504 |
| Full Name | Santa Rosa Medical Centers Of Nevada, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4161 S Eastern Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Syed I Pervaiz (PRESIDENT) |
| Authorized Official Contact | 7026936222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rosa Medical Centers Of Nevada, Inc. 4161 S Eastern Ave Suite B3 Las Vegas NV 89119-5484 Ph: (702) 693-6222 | Santa Rosa Medical Centers Of Nevada, Inc. 4161 S Eastern Ave Suite B3 Las Vegas NV 89119-5484 Ph: (702) 693-6222 |
| NPI Number | 1912155110 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 08/16/2022 |
| Medicare PECOS PAC ID | 4587716964 |
|---|---|
| Medicare Enrollment ID | O20090715000705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912155110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 11875 (Nevada) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Syed Irshad Hussain Pervaiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326079096 PECOS PAC ID: 5799776050 Enrollment ID: I20061027000091 |
| Provider Name | Shehzad M Parekh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023027307 PECOS PAC ID: 4284737495 Enrollment ID: I20070831000136 |
| Provider Name | Asher Shahzad |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457519332 PECOS PAC ID: 0941374565 Enrollment ID: I20110321000838 |
| Provider Name | Francisco Antonio B Corpuz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679846737 PECOS PAC ID: 9537320809 Enrollment ID: I20120412000563 |
| Provider Name | Amber D Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386813046 PECOS PAC ID: 2466649744 Enrollment ID: I20120716000577 |
| Provider Name | Rowena P Panganiban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538503677 PECOS PAC ID: 7214175199 Enrollment ID: I20130605000120 |
| Provider Name | Maria Lourdes Roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124471099 PECOS PAC ID: 5496027716 Enrollment ID: I20170822002148 |
| Provider Name | Shinly Marie Karl Pangilinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477023067 PECOS PAC ID: 5799024576 Enrollment ID: I20190222002234 |
| Provider Name | Rhia Joy Lumanog Dizon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386205052 PECOS PAC ID: 1153755343 Enrollment ID: I20191220001953 |
| Provider Name | Khalil Ibrahim Bourji |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1184070815 PECOS PAC ID: 7113218108 Enrollment ID: I20210614002898 |
| Provider Name | Deokchol Parish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841885142 PECOS PAC ID: 0042611196 Enrollment ID: I20210625002097 |
| Provider Name | Jency Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821760307 PECOS PAC ID: 6709278393 Enrollment ID: I20220111000771 |
| Provider Name | Stephanie Nicole Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285248898 PECOS PAC ID: 7810384567 Enrollment ID: I20220427000671 |
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