Active NPI
Sandra Lipovaca, M.D.
- Pediatrics Physician
- North Las Vegas, NV
National Provider Identifier
1003144858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13353
- Practice address
- 1905 Civic Center Dr
North Las Vegas, NV 89030-7143 - Phone
- (702) 877-9514
- Fax
- (702) 312-3510
- NPI assigned
- Dec 4, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13353 | NV | Primary |
Addresses
Primary practice location
1905 Civic Center Dr
North Las Vegas, NV 89030-7143
Mailing address
5701 W Charleston Blvd
Suite 100
Las Vegas, NV 89146-1217
Phone (702) 877-9514
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13353 | Other | NV | LICENSE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13353 | NV | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1003144858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 W CHARLESTON BLVD",
"address_2": "SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891461217",
"telephone_number": "702-877-9514",
"fax_number": "702-312-3510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 CIVIC CENTER DR",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890307143",
"telephone_number": "702-877-9514",
"fax_number": "702-312-3510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPOVACA",
"first_name": "SANDRA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-04",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "13353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "13353",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.