NPIMap

Organization Active NPI

Vishal Gandotra MD PC

Doing business as Vishal Gandotra MD Inc

  • Gastroenterology Physician
  • Las Vegas, NV
National Provider Identifier
1083864177
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
10594 Issued in NV
Legal business name
VISHAL GANDOTRA MD PC
Doing business as
Vishal Gandotra MD Inc
Practice address
5701 W Charleston Blvd Ste 201
Las Vegas, NV 89146-0903
Phone
(702) 750-0313
Fax
(702) 487-3197
NPI assigned
Sep 24, 2008
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Dr. Vishal Gandotra, MDNPI 1336137603
Title
President
Phone
(702) 528-3557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 10594 NV Primary

Addresses

Primary practice location

5701 W Charleston Blvd Ste 201
Las Vegas, NV 89146-0903

Mailing address

1930 Village Center Cir Ste 3-448
Las Vegas, NV 89134-6299
Phone (702) 528-3557

Other practice location 1

6850 N Durango Dr Ste 302
Las Vegas, NV 89149-4597
Phone (702) 750-0313

Other names 1

  • Vishal Gandotra MD Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081111000217 NV Part B Supplier - Clinic/Group Practice 6800955410 Receives reassigned benefits from 12 practitioners
Practice locations: Las Vegas, NV; North Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

1350 E Flamingo Rd
#480
Las Vegas, NV 89119
Phone (702) 528-3557

1930 Village Center Cir
#3448
Las Vegas, NV 89134

1930 Village Center Cir
Ste 3448
Las Vegas, NV 89134

5701 W Charleston Blvd
Ste 201
Las Vegas, NV 89146
Phone (702) 750-0313

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1083864177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 VILLAGE CENTER CIR STE 3-448",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346299",
            "telephone_number": "702-528-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD STE 201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460903",
            "telephone_number": "702-750-0313",
            "fax_number": "702-487-3197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6850 N Durango Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494597",
            "country_code": "US",
            "telephone_number": "702-750-0313",
            "fax_number": "702-487-3197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISHAL GANDOTRA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "GANDOTRA",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-528-3557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "10594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vishal Gandotra MD Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.