Individual provider Active NPI

Rodezza Sacayan Tabano, PA

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1013696301
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2992 Issued in NV
Practice address
3175 Saint Rose Pkwy Ste 121
Henderson, NV 89052-3507
Phone
(702) 802-5100
NPI assigned
Jul 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2992 NV Primary

Addresses

Primary practice location

3175 Saint Rose Pkwy Ste 121
Henderson, NV 89052-3507

Mailing address

3175 Saint Rose Pkwy Ste 121
Henderson, NV 89052-3507

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203003454 NV Practitioner - Physician Assistant 1658801873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ferdowsian, Global Services PLLCGroup PAC ID 1658425210, 7 clinicians

Practice addresses (Care Compare)

3175 Saint Rose Pkwy
Suite 121
Henderson, NV 89052-3506

3175 Saint Rose Pkwy
Suite 121
Henderson, NV 89052-3507
Phone (702) 802-5100

3551 E Bonanza Rd
Las Vegas, NV 89110-2198

8530 W Sunset Rd
Suite 110
Las Vegas, NV 89113-2244
Phone (702) 754-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2992NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1013696301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 SAINT ROSE PKWY STE 121",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 SAINT ROSE PKWY STE 121",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523507",
            "telephone_number": "702-802-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABANO",
        "first_name": "RODEZZA",
        "middle_name": "SACAYAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.