NPIMap

Individual provider Active NPI

Suparna N Shah, MD

  • Otolaryngology Physician
  • Las Vegas, NV
National Provider Identifier
1023498276
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
23056 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1807
Phone
(702) 671-6480
Fax
(702) 671-6481
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD198475 OR
Otolaryngology Physician 207Y00000X 23056 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1807

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-2315

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230123002389 NV Practitioner - Otolaryngology 8224469960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York Medical College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

5320 S Rainbow Blvd
Suite 260
Las Vegas, NV 89118-1896
Phone (702) 405-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23056NVMDOtolaryngology Physician
MD198475ORMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Jan 1, 2023 Accepting new patients
Unlv Medicine CurrentSince Jan 1, 2023 Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Locations

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

5320 S Rainbow Blvd
Ste 250
Las Vegas, NV 89118
Phone (702) 671-6480

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1023498276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2315",
            "fax_number": "702-895-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181807",
            "telephone_number": "702-671-6480",
            "fax_number": "702-671-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUPARNA",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD198475",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NV",
            "license": "23056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.