Individual provider Active NPI

Maksim Baletic

  • Attendant Care Provider
  • Las Vegas, NV
National Provider Identifier
1083330104
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
4955 S Durango Dr
Las Vegas, NV 89113-0152
Phone
(028) 712-2737
NPI assigned
Oct 19, 2022
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X NU
Adult Companion 372600000X NU
Attendant Care Provider 3747A0650X NU Primary
Homemaker 376J00000X NU

Addresses

Primary practice location

4955 S Durango Dr
Las Vegas, NV 89113-0152

Mailing address

4955 S Durango Dr
Las Vegas, NV 89113-0152
Phone (702) 871-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1083330104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 S DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130152",
            "telephone_number": "702-871-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130152",
            "telephone_number": "028-712-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALETIC",
        "first_name": "MAKSIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.