Roberto Isai Soto-Gutierrez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2941 Issued in NV

Practice address

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317

Phone

(702) 961-7800

NPI assigned

Sep 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919

  Physician Assistant

  NPD

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1093591364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 AMERICAN PACIFIC DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148800",
            "telephone_number": "702-777-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092317",
            "telephone_number": "702-961-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "874 American Pacific Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890148800",
            "country_code": "US",
            "telephone_number": "702-777-8687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO-GUTIERREZ",
        "first_name": "ROBERTO",
        "middle_name": "ISAI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-04",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frida Fernanda Soto Chavez
• Maria Soto de Maya
• Gladis Maria Soto Lavadi
• Teresita De Jesus Soto Lopez
• Maria G Soto Torres
• Maria Soto-Preciado
• Alejandra Marisol Soto
• Alina Soto
• Amy Soto
• Antonio Soto

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.