Individual provider Active NPI

Stanley Scott Poole, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Las Vegas, NV
National Provider Identifier
1053759282
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DO2192 Issued in NV
Practice address
3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone
(702) 731-8000
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X SL0953 NV
Physical Medicine & Rehabilitation Physician 208100000X SL0953 NV
Physical Medicine & Rehabilitation Physician 208100000X DO2192 NV Primary

Addresses

Primary practice location

3186 S Maryland Pkwy
Las Vegas, NV 89109

Mailing address

PO Box 734639
Chicago, IL 60673-4639
Phone (702) 242-6911

Other practice location 1

5901 E 7th St
Long Beach, CA 90822-5201
Phone (562) 826-8000

Other practice location 2

5901 E 7th St
Long Beach, CA 90822-5201
Phone (562) 826-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170712003910 NV Practitioner - Physical Medicine and Rehabilitation 9638487275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Physical Medicine and Rehabilitation PCGroup PAC ID 9133479546, 27 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (702) 388-4000

Hospital & facility affiliations

  • St Agatha Home Health LLC Home health agency, Henderson, NV, CCN 297271
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Sunrise Hospital Medical Center Inpatient rehabilitation facility, Las Vegas, NV, CCN 29T003
  • Dignity Health Rehabilitation Hospital Inpatient rehabilitation facility, Henderson, NV, CCN 293035
  • Pam Rehabilitation Hospital of Centennial Hills Inpatient rehabilitation facility, Las Vegas, NV, CCN 293034

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13767CAMDOptometrist
SL0953NVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Physical Medicine and Rehabilitation PC Physical Medicine & Rehabilitation CurrentSince Aug 11, 2017 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Dignity Select Nevada LLC Past Accepting new patients

Locations

12 Commerce Center Dr
Ste D44
Henderson, NV 89014

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

840 S Rancho Dr
Ste 4740
Las Vegas, NV 89106
Phone (702) 242-6911

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1053759282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734639",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734639",
            "telephone_number": "702-242-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89109",
            "telephone_number": "702-731-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5901 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "STANLEY",
        "middle_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "SL0953",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": "SL0953",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": "DO2192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.