NPIMap

Individual provider Active NPI

Stephanie A Wishnev, MD

  • Colon & Rectal Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1043219686
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
8168 Issued in NV
Practice address
6020 S. Jones Blvd
Las Vegas, NV 89118-2310
Phone
(702) 739-6467
Fax
(702) 733-1689
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 8168 NV Primary

Addresses

Primary practice location

6020 S. Jones Blvd
Las Vegas, NV 89118-2310

Mailing address

PO Box 50607
Henderson, NV 89016-0607

Other identifiers 1

IdentifierTypeStateIssuer
002002280MedicaidNV

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
I20051004000686 NV Practitioner - Colorectal Surgery (Proctology) 1153356571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Northwestern University Feinberg Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stephanie a Wishnev MD LTDGroup PAC ID 5991720195, 2 clinicians

Practice addresses (Care Compare)

6020 S Jones Blvd
Las Vegas, NV 89118-2619
Phone (702) 739-6467

Hospital & facility affiliations

  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy62
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8168NVMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Women'S Cancer Center of Nevada Inc Past Accepting new patients

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.

Hospital & facility affiliations 6

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1043219686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50607",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890160607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 S. JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182310",
            "telephone_number": "702-739-6467",
            "fax_number": "702-733-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHNEV",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NV",
            "license": "8168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002280",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.