Tresa Chakkalakkal, MD

Individual provider Active NPI Pediatrics Physician · Las Vegas, NV

NPI 1053535906 · NPPES record last updated Sep 5, 2026

Key facts

NPI
1053535906
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
12578 (NV)
Practice address
653 N Town Center Dr
Suite 106
Las Vegas, NV 89144-0514
Phone
(702) 363-3000
Fax
(702) 363-3161
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002415NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Sunshine Valley Health Care-Wesley J. Robertson M.D. Prof. Corp. Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12578 NV Yes

Addresses

Primary practice location

653 N Town Center Dr
Suite 106
Las Vegas, NV 89144-0514

Mailing address

43 Moonfire Dr
Las Vegas, NV 89135-7800
Phone (702) 461-3014

Other identifiers

IdentifierTypeStateIssuer
2682259MedicaidNY

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Pediatrics Physician in Nevada

Sources for this page

Verify at the official NPI Registry.