NPIMap

Organization Active NPI

Rehab Directives LLC

  • Rehabilitation Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1104214055
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
REHAB DIRECTIVES LLC
Practice address
3165 N Rainbow Blvd
Las Vegas, NV 89108-4578
Phone
(702) 570-6222
NPI assigned
Dec 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Mr. Donato Baltazar Laza, OTRNPI 1952504102
Title
Co-Owner
Phone
(702) 499-3764

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
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

3165 N Rainbow Blvd
Las Vegas, NV 89108-4578

Mailing address

3165 N Rainbow Blvd
Las Vegas, NV 89108-4578
Phone (702) 570-6222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150304000767 NV Part B Supplier - Clinic/Group Practice 5799001087 Receives reassigned benefits from 5 practitioners
Practice locations: Las Vegas, NV; North Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Rehab Directives LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5975 W Twain Ave
Las Vegas, NV 89103
Phone (702) 364-1111

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1104214055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3165 N RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084578",
            "telephone_number": "702-570-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 N RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084578",
            "telephone_number": "702-570-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB DIRECTIVES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "LAZA",
        "authorized_official_first_name": "DONATO",
        "authorized_official_middle_name": "BALTAZAR",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "702-499-3764",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "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 Oct 22, 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.