NPIMap

Organization Active NPI

Siena Hills Primary Care

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1003903527
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7222 Issued in NV
Legal business name
SIENA HILLS PRIMARY CARE
Practice address
2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052
Phone
(702) 614-0850
Fax
(702) 614-0798
NPI assigned
Oct 6, 2006
Last updated
Aug 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Authorized official

Name
Dr. Robert Charles Gong, M.D.NPI 1265409601
Title
Managing Owner
Phone
(702) 614-0850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 7222 NV Primary

Addresses

Primary practice location

2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052

Mailing address

2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052-5052
Phone (702) 614-0850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050106000084 NV Part B Supplier - Clinic/Group Practice 1254389216 Receives reassigned benefits from 3 practitioners
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Locations

2789 Sunridge Heights Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 614-0850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIFHCA

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533513600000",
    "number": "1003903527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 SUNRIDGE HEIGHTS PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525052",
            "telephone_number": "702-614-0850",
            "fax_number": "702-614-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 SUNRIDGE HEIGHTS PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-614-0850",
            "fax_number": "702-614-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIENA HILLS PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2018-08-06",
        "status": "A",
        "authorized_official_last_name": "GONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "702-614-0850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "7222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.