Edmond Elias Pack, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

9904 Issued in NV

Practice address

8285 W Arby Ave Ste 280
Las Vegas, NV 89113-2246

Phone

(702) 862-8862

Fax

(702) 862-8774

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

New York Medical College, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Women'S Health Associates of Southern Nevada- Martin, PLLCGroup PAC ID 4082845664, 111 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4
• Direct secure messaging: edmond.pack@whasn.eclinicaldirectplus.com

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.

• Women'S Health Associates of Southern Nevada- Martin, PLLC

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
  • NPI 1598906166
  Medicare reassignment Care Compare group
• Desert Springs Hospital

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1154317964
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)
• Henderson Hospital

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1003281452
  NPD (past)
• Southern Hills Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1457306359
  NPD (past)
• Spring Valley Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1346230323
  NPD (past)
• Spring Valley Medical Center

  • Rehabilitation Hospital Unit
  • Las Vegas, NV
  • NPI 1568439693
  NPD (past)
• Sunrise Hospital and Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1689611774
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605312000000",
    "number": "1043284334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 SPANISH RIDGE AVE STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481319",
            "telephone_number": "702-330-3102",
            "fax_number": "702-912-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8285 W ARBY AVE STE 280",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132246",
            "telephone_number": "702-862-8862",
            "fax_number": "702-862-8774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2580 Saint Rose Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890747792",
            "country_code": "US",
            "telephone_number": "702-862-8862",
            "fax_number": "702-862-8774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACK",
        "first_name": "EDMOND",
        "middle_name": "ELIAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "9904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacifica Spring Valley LLC
• Pacifica Vintage Park LLC
• Ruffa Mae Manangan Pacifico
• Pacificus Mental Health LLC
• Natalie Dorothy Pacitto, LPC, LLP, CPC
• Sheresa Pack
• Zachary Bryan Pack, PA-C
• Angelena Packard
• Nylasia Packer
• Taylor Packwood

• Obstetrics & Gynecology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Obstetrics & Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.