Individual provider Active NPI

Ranjit Jain, M.D.

  • Urology Physician
  • Las Vegas, NV
National Provider Identifier
1053374744
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4880 Issued in NV
Practice address
700 Shadow LN
430
Las Vegas, NV 89106-4126
Phone
(702) 384-0500
Fax
(702) 384-0093
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4880 NV Primary

Addresses

Primary practice location

700 Shadow LN
430
Las Vegas, NV 89106-4126

Mailing address

700 Shadow LN
430
Las Vegas, NV 89106-4126
Phone (702) 384-0500

Other identifiers 1

IdentifierTypeStateIssuer
2002903MedicaidNV

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000687 NV Practitioner - Urology 5294718466 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4880NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Jun 12, 2017 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 12, 2017 Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

2010 Wellness Way
Ste 200
Las Vegas, NV 89106
Phone (702) 382-2900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1053374744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHADOW LN",
            "address_2": "430",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064126",
            "telephone_number": "702-384-0500",
            "fax_number": "702-384-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHADOW LN",
            "address_2": "430",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064126",
            "telephone_number": "702-384-0500",
            "fax_number": "702-384-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RANJIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NV",
            "license": "4880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002903",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.