Dennis Fajardo, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2469 Issued in NV

Practice address

330 S Casino Center Blvd
Las Vegas, NV 89101-6102

Phone

(702) 671-5638

NPI assigned

Oct 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Circle Medical Care of California

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1134596091
  NPD (past)

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1083378657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6288 HUMUS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891395457",
            "telephone_number": "702-639-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S CASINO CENTER BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016102",
            "telephone_number": "702-671-5638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 W 6th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928821644",
            "country_code": "US",
            "telephone_number": "888-873-6220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "DENNIS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA60732",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amarga Fajardo, RD, LD
• Ana Fajardo
• Angeli Fajardo
• Antonia Esther Alonso Fajardo, APRN, FNPC
• Aurora Fajardo
• James Fajardo, RN
• Karla V Fajardo, NP
• Natalya Ann Fajardo, DC
• Noel R Fajardo, M.D.
• Rita Fajardo

• Medical Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.