Individual provider Active NPI

Heather Lee Ta, PA-C

  • Surgical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1043460876
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1132 Issued in NV
Practice address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 1132 NV
Surgical Physician Assistant 363AS0400X PA1132 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609

Mailing address

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Other practice location 1

8402 Centennial Pkwy
Las Vegas, NV 89149-4792
Phone (702) 731-1616

Other practice location 2

8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 731-1616

Other practice location 3

2930 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5059
Phone (702) 731-1616

Other identifiers 1

IdentifierTypeStateIssuer
PA1132OtherNVNV MEDICAL LICENSE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000470 NV Practitioner - Physician Assistant 7517023732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

8402 Centennial Pkwy
Suite 240
Las Vegas, NV 89149-4793
Phone (702) 731-1616

Hospital & facility affiliations

  • Henderson Hospital Hospital, Henderson, NV, CCN 290057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 1132NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hills Medical Center, LLC Past Accepting new patients
Desert Orthopaedic Billing LLC Orthopaedic Surgery Past Accepting new patients
Integrative Family Medicine Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tahel@doclv.emadirect.md

Organizations & group practices 4

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 3

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1043460876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494792",
            "country_code": "US",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8205 W Warm Springs Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133646",
            "country_code": "US",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2930 W Horizon Ridge Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890525059",
            "country_code": "US",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TA",
        "first_name": "HEATHER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA 1132",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LICENSE",
            "identifier": "PA1132",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.