Individual provider Active NPI

Saravanan Valliappan, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1003805045
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
16477 Issued in NV
Practice address
5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872
Phone
(702) 477-0772
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 16477 NV Primary

Addresses

Primary practice location

5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872

Mailing address

PO Box 30077
Salt Lake City, UT 84130-0077
Phone (702) 477-0772

Other practice location 1

2001 N Oregon St
El Paso, TX 79902-3320
Phone (915) 577-6011

Other identifiers 5

IdentifierTypeStateIssuer
286234401MedicaidTX
P00950241OtherTXRR MEDICARE
515207OtherAZAHCCCS
263650OtherAZVRL
8CT588OtherTXBCBS TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804002749 NV Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8325038474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Hahnemann University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pueblo Medical Imaging LLCGroup PAC ID 2264328319, 22 clinicians
J Paul Wiesner and Associates CharteredGroup PAC ID 4880679976, 24 clinicians

Practice addresses (Care Compare)

1941 Jefferson St
Suite 105
North Las Vegas, NV 89030-6960
Phone (702) 228-0031

2628 W Charleston Blvd
Las Vegas, NV 89102-2176
Phone (702) 228-0031

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5585

5495 S Rainbow Blvd
Suite 101
Las Vegas, NV 89118-1872
Phone (702) 228-0031

8551 W Lake Mead Blvd
Suite 150
Las Vegas, NV 89128-7649
Phone (702) 228-0031

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053
  • West Henderson Hospital Hospital, Henderson, NV, CCN 290062
  • North Vista Hospital Hospital, North Las Vegas, NV, CCN 290005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16477NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Medical Imaging, LLC Diagnostic Radiology CurrentSince Jun 5, 2017 Accepting new patients
J Paul Wiesner & Associates Chartered Diagnostic Radiology CurrentSince Jun 21, 2016 Accepting new patients
Inland Imaging LLC Diagnostic Radiology Past Accepting new patients
Medical Imaging Physicians Inc Diagnostic Radiology Past Accepting new patients
Integra Imaging, PS Diagnostic Radiology Past Accepting new patients
Simonmed Imaging, Incorporated Diagnostic Radiology Past Accepting new patients
Kashyap Patel MD PA Past Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology PastSince Apr 20, 2021 Accepting new patients
Northwest Cardiac and Vascular Imaging, LLC PastSince Nov 1, 2004 Accepting new patients
Inland Pacific Imaging LLC Past Accepting new patients
Inland Imaging Associates PS Diagnostic Radiology Past Accepting new patients
South Shore Imaging Inc Diagnostic Radiology Past Accepting new patients
Inland Imaging Arizona LLC Diagnostic Radiology Past Accepting new patients
Inland Imaging Associates, PS Diagnostic Radiology Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074
Phone (702) 990-7417

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

8551 W Lake Mead Blvd
Ste 150
Las Vegas, NV 89128
Phone (702) 683-5516

2628 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 644-0500

5495 S Rainbow Blvd
Ste 101
Las Vegas, NV 89118
Phone (702) 214-9729

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1003805045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30077",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300077",
            "telephone_number": "702-477-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 S RAINBOW BLVD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181872",
            "telephone_number": "702-477-0772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 N Oregon St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799023320",
            "country_code": "US",
            "telephone_number": "915-577-6011",
            "fax_number": "915-577-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLIAPPAN",
        "first_name": "SARAVANAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "16477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286234401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00950241",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "515207",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VRL",
            "identifier": "263650",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8CT588",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.