Organization Active NPI

Hygeia Wellness Center LLC

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1023730421
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HYGEIA WELLNESS CENTER LLC
Practice address
2810 W Charleston Blvd Ste 77
Las Vegas, NV 89102-1910
Phone
(702) 445-6323
Fax
(702) 749-3156
NPI assigned
Sep 13, 2022
Last updated
Mar 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Yissel Del RioNPI 1346978863
Title
Managing Member
Phone
(702) 769-5913

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Internal Medicine Physician 207R00000X Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

2810 W Charleston Blvd Ste 77
Las Vegas, NV 89102-1910

Mailing address

2810 W Charleston Blvd Ste 77
Las Vegas, NV 89102-1910
Phone (702) 445-6323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719002801 NV Part B Supplier - Clinic/Group Practice 0042670218 Receives reassigned benefits from 6 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2276752Hygeia Wellness Center LLC2810 W Charleston Blvd Suite 77, Las Vegas, NV 89102Certificate of waiverFeb 13, 2027

National Provider Directory

National Provider Directory

Locations

2810 W Charleston Blvd
Ste 77
Las Vegas, NV 89102
Phone (702) 445-6323

2810 W Charleston Blvd
Ste H77
Las Vegas, NV 89102
Phone (702) 377-6556

Practitioners & affiliated clinicians

Practitioners 10

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": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1023730421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD STE 77",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021910",
            "telephone_number": "702-445-6323",
            "fax_number": "702-749-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD STE 77",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021910",
            "telephone_number": "702-445-6323",
            "fax_number": "702-749-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYGEIA WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "DEL RIO",
        "authorized_official_first_name": "YISSEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-769-5913"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Mar 11, 2024; 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.