Individual provider Active NPI

Benjamin J McGarvey, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1053551374
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1636 Issued in NV
Practice address
9800 W. Skye Cayon Park Dr
Ste #170
Las Vegas, NV 89166
Phone
(702) 425-5119
Fax
(702) 213-6079
NPI assigned
Feb 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 PA1636 NV Primary

Addresses

Primary practice location

9800 W. Skye Cayon Park Dr
Ste #170
Las Vegas, NV 89166

Mailing address

9800 W Skye Canyon Park Dr Ste 170
Las Vegas, NV 89166-6631
Phone (702) 425-5119

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

State licenses

LicenseStateTypeSpecialty
PA1636NVMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1053551374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 W SKYE CANYON PARK DR STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666631",
            "telephone_number": "702-425-5119",
            "fax_number": "702-213-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 W. SKYE CAYON PARK DR",
            "address_2": "STE #170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89166",
            "telephone_number": "702-425-5119",
            "fax_number": "702-213-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGARVEY",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1636",
            "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 Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.