Individual provider Active NPI

Edgardo Averion Faylona, M.D.

  • Hematology & Oncology Physician
  • Las Vegas, NV
National Provider Identifier
1083611362
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
6872 Issued in NV
Practice address
2300 W Charleston Blvd
Las Vegas, NV 89102-2149
Phone
(702) 724-8787
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 6872 NV Primary

Addresses

Primary practice location

2300 W Charleston Blvd
Las Vegas, NV 89102-2149

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Other identifiers 3

IdentifierTypeStateIssuer
002019348MedicaidNV
830003909OtherNVRAILROAD MEDICARE
453457MedicaidAZ

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
I20100830001098 NV Practitioner - Hematology/Oncology 8224126602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group Rhodes P CGroup PAC ID 1052390036, 53 clinicians

Practice addresses (Care Compare)

6190 S Fort Apache Rd
Las Vegas, NV 89148-6702
Phone (702) 724-8787

Merit-based Incentive Payment System (MIPS)

Final score
89.7 of 100Reported as group
Quality
82.63
Promoting interoperability
100
Improvement activities
40
Cost
83.03

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Sep 1, 2016 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Sep 1, 2016 Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

6190 S Fort Apache Rd
Las Vegas, NV 89148
Phone (702) 485-5885

2300 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 724-8787

Interoperability endpoints

  • Direct secure messaging: efaylona118003@westdirect.optum.com
  • Direct secure messaging: edgardo.faylona.p4@direct.uson.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1083611362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022149",
            "telephone_number": "702-724-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYLONA",
        "first_name": "EDGARDO",
        "middle_name": "AVERION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NV",
            "license": "6872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019348",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830003909",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453457",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.