Organization Active NPI

Iriye Medical Group PLLC

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
National Provider Identifier
1033803986
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
IRIYE MEDICAL GROUP PLLC
Practice address
2011 Pinto LN Ste 200
Las Vegas, NV 89106-4007
Phone
(702) 382-3200
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Kim Mandujano
Title
Administrative Asst
Phone
(702) 382-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

2011 Pinto LN Ste 200
Las Vegas, NV 89106-4007

Mailing address

2011 Pinto LN Ste 200
Las Vegas, NV 89106-4007

Other practice location 1

1528 W Warm Springs Rd Ste 100
Henderson, NV 89014-4332
Phone (702) 382-3200

Other practice location 2

8480 S Eastern Ave Ste F
Las Vegas, NV 89123-2822
Phone (702) 382-3200

Other practice location 3

6850 N Durango Dr Ste 401
Las Vegas, NV 89149-4598
Phone (702) 382-3200

Other practice location 4

861 Coronado Center Dr Ste 131
Henderson, NV 89052-3992
Phone (702) 382-3200

National Provider Directory

National Provider Directory
Tax ID family
Iriye Medical Group PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6850 N Durango Dr
Ste 401
Las Vegas, NV 89149
Phone (702) 463-2981

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1033803986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 PINTO LN STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 PINTO LN STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064007",
            "telephone_number": "702-382-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1528 W Warm Springs Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890144332",
            "country_code": "US",
            "telephone_number": "702-382-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8480 S Eastern Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891232822",
            "country_code": "US",
            "telephone_number": "702-382-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6850 N Durango Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494598",
            "country_code": "US",
            "telephone_number": "702-382-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "861 Coronado Center Dr Ste 131",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523992",
            "country_code": "US",
            "telephone_number": "702-382-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IRIYE MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "MANDUJANO",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASST",
        "authorized_official_telephone_number": "702-382-3200"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.