Organization Active NPI

Generations Med Center LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1063961027
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GENERATIONS MED CENTER LLC
Practice address
8225 W Sahara Ave Ste C
Las Vegas, NV 89117-8929
Phone
(725) 251-6390
Fax
(725) 251-6712
NPI assigned
Sep 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Jennie InguanzoNPI 1023303104
Title
Chief Executive Officer
Phone
(702) 476-2899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

8225 W Sahara Ave Ste C
Las Vegas, NV 89117-8929

Mailing address

8225 W Sahara Ave Ste C
Las Vegas, NV 89117-8929
Phone (702) 476-2899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170828003562 NV Part B Supplier - Clinic/Group Practice 3173895067 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2134853Generations Med Center LLC8225 W Sahara Ave, Suite C, Las Vegas, NV 89117Certificate of waiverOct 1, 2027

National Provider Directory

National Provider Directory

Locations

8225 W Sahara Ave
Ste C
Las Vegas, NV 89117
Phone (725) 251-6390

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2262/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1063961027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 W SAHARA AVE STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891178929",
            "telephone_number": "702-476-2899",
            "fax_number": "702-476-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 W SAHARA AVE STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891178929",
            "telephone_number": "725-251-6390",
            "fax_number": "725-251-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS MED CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "INGUANZO",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "702-476-2899"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "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 Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.