Individual provider Active NPI

Pandora Williams, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1093787210
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1665 Issued in NV
Practice address
4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone
(702) 871-5005
Fax
(702) 871-1341
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1613 AZ
Physician Assistant 363A00000X PA1665 NV Primary

Addresses

Primary practice location

4880 Wynn Rd
Las Vegas, NV 89103-5406

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
181032MedicaidAZ
1093787210MedicaidNV

Other names 1

  • Pandora Hector-Lewis Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223000306 NV Practitioner - Physician Assistant 4183772569 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eduardo Ramos MD PLLCGroup PAC ID 6406225143, 6 clinicians

Practice addresses (Care Compare)

4472 S Eastern Ave
Las Vegas, NV 89119-7825
Phone (702) 202-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1613AZMDGeneral Practice Dentistry
PA1665NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CRFP, P.L.L.C. Current Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients

Locations

5610 E Grant Rd
Tucson, AZ 85712
Phone (520) 296-5035

8275 N Silverbell Rd
Ste 113
Tucson, AZ 85743
Phone (520) 382-8202

Organizations & group practices 5

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093787210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 WYNN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035406",
            "telephone_number": "702-871-5005",
            "fax_number": "702-871-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PANDORA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1613",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181032",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093787210",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PANDORA",
            "last_name": "HECTOR-LEWIS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.