Farrukh Imtiaz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9523 Issued in NV

Practice address

3650 S Eastern Ave
Ste 210
Las Vegas, NV 89169-3345

Phone

(702) 933-6768

Fax

(702) 933-6770

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Farrukh Imtiaz MD a Professional Corporation

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1548008956
  Medicare reassignment NPD Authorized official

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

• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  Care Compare affiliation

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1063404663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 S EASTERN AVE",
            "address_2": "SUITE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693379",
            "telephone_number": "702-933-6768",
            "fax_number": "702-933-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 S EASTERN AVE",
            "address_2": "STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693345",
            "telephone_number": "702-933-6768",
            "fax_number": "702-933-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMTIAZ",
        "first_name": "FARRUKH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002018400",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Improved Mind Health Center LLC
• Ims Behavioral Health LLC
• Ims Behavioral Health LLC
• Ims Behavioral Health Services LLC
• Ims of Las Vegas Hospitalist, LTD
• In a Visit LLC
• In Focus Behavioral Health LLC
• In Good Health Professional Corporation
• In Touch Mental Health, LLC
• In-House Home Health Inc

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.