NPIMap

Individual provider Active NPI

Suhattai Gamnerdsiri, M.D.

  • Cardiovascular Disease Physician
  • Las Vegas, NV
National Provider Identifier
1073618138
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9094 Issued in NV
Practice address
2000 Pinto LN Ste 200
Las Vegas, NV 89106-4066
Phone
(702) 367-9300
Fax
(702) 367-9400
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9094 NV Primary

Addresses

Primary practice location

2000 Pinto LN Ste 200
Las Vegas, NV 89106-4066

Mailing address

1000 N Green Valley Pkwy # 440-398
Henderson, NV 89074-6170
Phone (702) 260-4107

Other identifiers 3

IdentifierTypeStateIssuer
CC1182OtherNVNV BLUE SHIELD
002018154MedicaidNV
110227405OtherNVRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090706000462 NV Practitioner - Cardiovascular Disease (Cardiology) 9931250883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Hahnemann University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suhattai Gamnerdsiri MD LTDGroup PAC ID 5698910503, 6 clinicians

Practice addresses (Care Compare)

2000 Pinto LN
Suite 200
Las Vegas, NV 89106-4066
Phone (702) 367-9300

Hospital & facility affiliations

  • Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046

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 Medicine

State licenses

LicenseStateTypeSpecialty
9094NVMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suhattai Gamnerdsiri, M.D. LTD. Cardiovascular Disease CurrentSince Feb 4, 2013 Accepting new patients
Nevada Cardiology Professional Assn Cardiovascular Disease PastSince Oct 1, 2018 Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Locations

1000 N Green Valley Pkwy
#440398
Henderson, NV 89074

2000 Pinto Ln
Ste 200
Las Vegas, NV 89106
Phone (702) 367-9300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJCBA

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1073618138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N GREEN VALLEY PKWY # 440-398",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746170",
            "telephone_number": "702-260-4107",
            "fax_number": "702-896-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PINTO LN STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064066",
            "telephone_number": "702-367-9300",
            "fax_number": "702-367-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMNERDSIRI",
        "first_name": "SUHATTAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "9094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV BLUE SHIELD",
            "identifier": "CC1182",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018154",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110227405",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.