Active NPI
Jaimie Eva Wardinger, MD, MSC
- Neonatal-Perinatal Medicine Physician
- Las Vegas, NV
National Provider Identifier
1104312180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 25868
- Practice address
- 3100 N Tenaya Way
Las Vegas, NV 89128-0436 - Phone
- (702) 962-5000
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD475719 | PA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 25868 | NV | Primary |
Addresses
Primary practice location
3100 N Tenaya Way
Las Vegas, NV 89128-0436
Mailing address
9529 Sierra Summit Ave
Las Vegas, NV 89134-0113
Phone (586) 224-0282
Other practice location 1
47 New Scotland Ave Dept Of Pediatrics
Albany, NY 12208-3412
Phone (518) 262-6248
Other practice location 2
47 New Scotland Ave Dept Of
Albany, NY 12208-3412
Phone (518) 262-6248
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64107 | Medicaid | NY | |
| 1104312180 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190215000618 | NY | Order and Referring Only - Pediatric Medicine | 3577801679 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25868 | NV | MD | Neonatal-Perinatal Medicine Physician |
| MD475719 | PA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pokroy Medical Group of Nevada, LTD. | Neonatal-Perinatal Medicine | Past | Accepting new patients |
| Southern Hills Medical Center, LLC | Past | Accepting new patients | |
| Sunrise Mountainview Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Neonatal-Perinatal Medicine Physician
- Las Vegas, NV
- NPI 1992809412
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1457306359
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1104870187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762819200000",
"number": "1104312180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9529 SIERRA SUMMIT AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891340113",
"telephone_number": "586-224-0282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 N TENAYA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280436",
"telephone_number": "702-962-5000"
}
],
"practiceLocations": [
{
"address_1": "47 New Scotland Ave Dept Of Pediatrics",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083412",
"country_code": "US",
"telephone_number": "518-262-6248",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "47 New Scotland Ave Dept Of",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083412",
"country_code": "US",
"telephone_number": "518-262-6248",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WARDINGER",
"first_name": "JAIMIE",
"middle_name": "EVA",
"name_prefix": "Dr.",
"credential": "MD, MSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-02",
"last_updated": "2025-11-11",
"certification_date": "2025-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "PA",
"license": "MD475719",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NV",
"license": "25868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64107",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104312180",
"state": "NV"
}
],
"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 Nov 11, 2025; 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.