Individual provider Active NPI

Angela Hawkins, P.A.-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1053417345
Registry record updated Feb 9, 2018
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Jun 20, 2018.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA816 Issued in NV
Practice address
911 N Buffalo Dr
Suite 113
Las Vegas, NV 89128-0379
Phone
(702) 987-1555
Fax
(702) 541-9180
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA816 NV Primary

Addresses

Primary practice location

911 N Buffalo Dr
Suite 113
Las Vegas, NV 89128-0379

Mailing address

PO Box 36190
Las Vegas, NV 89133-6190
Phone (702) 987-1555

Other practice location 1

911 N Buffalo Dr
Suite 113
Las Vegas, NV 89128-0379
Phone (702) 987-1555 ext. 111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA816NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
RB Vance II DO LTD Past Accepting new patients
Lake Mead Emergency Physicians, LLC Past Accepting new patients

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518134400000",
    "number": "1053417345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891336190",
            "telephone_number": "702-987-1555",
            "fax_number": "702-541-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N BUFFALO DR",
            "address_2": "SUITE 113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280379",
            "telephone_number": "702-987-1555",
            "fax_number": "702-541-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 N Buffalo Dr",
            "address_2": "Suite 113",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280379",
            "country_code": "US",
            "telephone_number": "702-987-1555 x111",
            "fax_number": "702-541-9180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "ANGELA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2018-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.