Active NPI
Lyle Mytzle A. Masangkay, CRT, RRT
- Registered Respiratory Therapist
- Las Vegas, NV
National Provider Identifier
1003102823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Respiratory Therapist
- License
- 121497
- Practice address
- 3611 Winter Wren St
Las Vegas, NV 89122-3540 - Phone
- (702) 461-1079
- NPI assigned
- Jun 20, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Respiratory Therapist | 227900000X | 121497 | NV | Primary |
Addresses
Primary practice location
3611 Winter Wren St
Las Vegas, NV 89122-3540
Mailing address
3611 Winter Wren St
Las Vegas, NV 89122-3540
Phone (702) 461-1079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121497 | NV | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1003102823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3611 WINTER WREN ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891223540",
"telephone_number": "702-461-1079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3611 WINTER WREN ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891223540",
"telephone_number": "702-461-1079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASANGKAY",
"first_name": "LYLE MYTZLE",
"middle_name": "A.",
"credential": "CRT, RRT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "227900000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered",
"state": "NV",
"license": "121497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.