Individual provider Active NPI

Douglas J Krasniewski, MPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1013954312
Registry record updated Jan 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1708 Issued in NV
Practice address
6590 S Rainbow Blvd Ste 230
Las Vegas, NV 89118-3322
Phone
(725) 726-7847
Fax
(725) 726-7876
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1708 NV Primary

Addresses

Primary practice location

6590 S Rainbow Blvd Ste 230
Las Vegas, NV 89118-3322

Mailing address

10785 W Twain Ave Ste 250
Las Vegas, NV 89135-3026
Phone (725) 726-7847

Other identifiers 1

IdentifierTypeStateIssuer
1013954312MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000997 NV Practitioner - Physical Therapist in Private Practice 9133151939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smith Therapy PartnersGroup PAC ID 1052731072, 46 clinicians

Practice addresses (Care Compare)

727 N Nellis Blvd
Las Vegas, NV 89110-5384
Phone (725) 726-7847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1708NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Therapy Partners Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
New Century Rehabilitation, LLC CurrentSince May 27, 2008 Accepting new patients
New Century Rehabilitation LLC Physical Therapist CurrentSince May 27, 2008 Accepting new patients
Thi of Nevada at Desert Valley Therapy, LLC Physical Therapist Past Accepting new patients
Sunrise Mountainview Hospital, Inc. PastSince Jan 17, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1505 Wigwam Pkwy
Ste 240
Henderson, NV 89074
Phone (702) 568-0195

1950 E Desert Inn Rd
Las Vegas, NV 89169
Phone (702) 735-1501

10785 W Twain Ave
Ste 250
Las Vegas, NV 89135

4000 S Eastern Ave
Ste 300
Las Vegas, NV 89119
Phone (702) 734-2732

6590 S Rainbow Blvd
Ste 230
Las Vegas, NV 89118
Phone (702) 326-0528

7121 W Craig Rd
Ste 110
Las Vegas, NV 89129

10040 Alta Dr
Ste 230
Las Vegas, NV 89145
Phone (725) 726-7947

727 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-4900

Organizations & group practices 5

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1013954312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10785 W TWAIN AVE STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353026",
            "telephone_number": "725-726-7847",
            "fax_number": "725-726-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6590 S RAINBOW BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183322",
            "telephone_number": "725-726-7847",
            "fax_number": "725-726-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNIEWSKI",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013954312",
            "state": "NV"
        }
    ],
    "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 Jan 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.