Active NPI
AIDS Healthcare Foundation
- Clinic/Center
- North Las Vegas, NV
National Provider Identifier
1053746933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- AIDS HEALTHCARE FOUNDATION
- Practice address
- 1815 E Lake Mead Blvd
Suite 113
North Las Vegas, NV 89030-7187 - Phone
- (323) 436-5019
- NPI assigned
- Sep 10, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donna Stidham
- Title
- Chief of Managed Care
- Phone
- (323) 436-5025
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
1815 E Lake Mead Blvd
Suite 113
North Las Vegas, NV 89030-7187
Mailing address
6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, NV
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050525000558 | FL | Part B Supplier - Clinic/Group Practice | 2668369109 |
Receives reassigned benefits from 75 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Miami Beach, FL; Ft Lauderdale, FL; North Miami Beach, FL; Orlando, FL; Pensacola, FL; Safety Harbor, FL; St Petersburg, FL; Tampa, FL… |
| O20140401001219 | NV | Part B Supplier - Clinic/Group Practice | 2668369109 |
Receives reassigned benefits from 7 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Las Vegas, NV; North Las Vegas, NV |
Other NPIs on the same Medicare enrollment 27
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinic/Center
- Las Vegas, NV
- NPI 1043645930
O20050525000558, O20140401001219
-
- Infectious Disease Physician
- Las Vegas, NV
- NPI 1447876156
O20140401001219
-
- Community/Retail Pharmacy
- North Miami Beach, FL
- NPI 1003866930
O20050525000558
-
- Internal Medicine Physician
- Miami Beach, FL
- NPI 1386926574
O20050525000558
National Provider Directory
National Provider DirectoryLocations
8390 Champions Gate Blvd
Champions Gate, FL 33896
Phone (407) 479-2000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1568160000000",
"number": "1053746933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 W SUNSET BLVD FL 21",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900287422",
"telephone_number": "323-860-5200",
"fax_number": "833-241-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 E LAKE MEAD BLVD",
"address_2": "SUITE 113",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890307187",
"telephone_number": "323-436-5019"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AIDS HEALTHCARE FOUNDATION",
"organizational_subpart": "NO",
"enumeration_date": "2013-09-10",
"last_updated": "2019-09-11",
"status": "A",
"authorized_official_last_name": "STIDHAM",
"authorized_official_first_name": "DONNA",
"authorized_official_title_or_position": "CHIEF OF MANAGED CARE",
"authorized_official_telephone_number": "323-436-5025"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North 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 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.