Individual provider Active NPI

J Cal Noorda, M.D.

  • Internal Medicine Physician
  • North Las Vegas, NV
National Provider Identifier
1073586087
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6278 Issued in NV
Practice address
1302 W Craig Rd
North Las Vegas, NV 89032
Phone
(702) 657-9555
Fax
(702) 657-9040
NPI assigned
Feb 9, 2006
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6278 NV Primary

Addresses

Primary practice location

1302 W Craig Rd
North Las Vegas, NV 89032

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 1

IdentifierTypeStateIssuer
1073586087MedicaidNV

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
I20061219000255 NV Practitioner - Internal Medicine 2466451539 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Nevada Asplin PC Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
KDMD, LLC Internal Medicine Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Internal Medicine Past Accepting new patients
Internal Medicine Associates Laboratory Past Accepting new patients
Copeland - Beajow Medical Institute, CHTD Internal Medicine Past Accepting new patients

Locations

2481 Professional Ct
Las Vegas, NV 89128
Phone (702) 213-8253

3425 Cliff Shadows Pkwy
Ste 250
Las Vegas, NV 89129
Phone (702) 382-1599

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1073586087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-657-9555",
            "fax_number": "702-657-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORDA",
        "first_name": "J",
        "middle_name": "CAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073586087",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.