Individual provider Active NPI

Reynald Pragados

  • Physical Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1093389165
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1131 Issued in NV
Practice address
6070 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5615
Phone
(702) 893-3333
Fax
(702) 893-0960
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-1131 NV Primary

Addresses

Primary practice location

6070 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5615

Mailing address

6070 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5615
Phone (702) 893-3333

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

State licenses

LicenseStateTypeSpecialty
A-1131NVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Hospice Care Inc PastSince May 16, 2021 Accepting new patients
Good Shepherd Rehab Centers of Las Vegas Inc PastSince May 16, 2021 Accepting new patients

Organizations & group practices 2

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1093389165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 S FORT APACHE RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485615",
            "telephone_number": "702-893-3333",
            "fax_number": "702-893-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 S FORT APACHE RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485615",
            "telephone_number": "702-893-3333",
            "fax_number": "702-893-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAGADOS",
        "first_name": "REYNALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1131",
            "primary": true
        }
    ],
    "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 May 13, 2021; 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.