Active NPI
Tresa Chakkalakkal, MD
- Pediatrics Physician
- Las Vegas, NV
National Provider Identifier
1053535906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 12578
- 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
- Last updated
- Sep 5, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12578 | NV | Primary |
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
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12578 | NV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Valley Health Care-Wesley J. Robertson M.D. Prof. Corp. | Pediatrics | Past | Accepting new patients |
| Summerlin Hospital Medical Center L L C | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Summerlin Hospital Medical Center
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1831189638
-
dba Sunshine Valley Pediatrics
- Pediatrics Physician
- Las Vegas, NV
- NPI 1164487930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788566400000",
"number": "1053535906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 MOONFIRE DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891357800",
"telephone_number": "702-461-3014",
"fax_number": "702-463-9546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 N TOWN CENTER DR",
"address_2": "SUITE 106",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891440514",
"telephone_number": "702-363-3000",
"fax_number": "702-363-3161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKKALAKKAL",
"first_name": "TRESA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2026-09-05",
"certification_date": "2026-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "12578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.