NPIMap

Organization Active NPI

Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1043030919
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SHADOW EMERGENCY PHYSICIANS PLLC
Practice address
10290 W Flamingo Rd
Las Vegas, NV 89135-2652
Phone
(954) 939-5000
NPI assigned
Oct 15, 2024
Last updated
Apr 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Edwin HomanskyNPI 1902859028
Title
Authorized Official
Phone
(469) 401-2386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

10290 W Flamingo Rd
Las Vegas, NV 89135-2652

Mailing address

PO Box 848252
Los Angeles, CA 90084-8252
Phone (954) 939-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111212000888 NV Part B Supplier - Clinic/Group Practice 2860667375 Receives reassigned benefits from 220 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Las Vegas, NV; Las Vegas, NV

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10290 W Flamingo Rd
Las Vegas, NV 89135

10290 W Flamingo Rd
Ste 100
Las Vegas, NV 89135
Phone (702) 369-7671

7230 N Decatur Blvd
Las Vegas, NV 89131
Phone (702) 534-7200

9217 S Cimarron Rd
Las Vegas, NV 89178
Phone (702) 776-4800

Practitioners & affiliated clinicians

Practitioners 177

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.

View all 177

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1043030919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848252",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900848252",
            "telephone_number": "954-939-5000",
            "fax_number": "877-250-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10290 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352652",
            "telephone_number": "954-939-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW EMERGENCY PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "HOMANSKY",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "469-401-2386"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "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 Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.