Individual provider Active NPI

Paul Bandt, M.D.

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1083670863
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2346 Issued in NV
Practice address
2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2346 NV Primary

Addresses

Primary practice location

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 3

IdentifierTypeStateIssuer
P01168990OtherNVRR MEDICARE
1083670863MedicaidCA
200290003MedicaidNV

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
I20080131000495 NV Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 0547174021 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Jan 1, 2020 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 21, 2012 Accepting new patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Sep 20, 1968 Accepting new patients

Locations

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

2020 Palomino Ln
Las Vegas, NV 89106
Phone (702) 384-5210

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

Organizations & group practices 3

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1083670863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDT",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "2346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01168990",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083670863",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290003",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.