Individual provider Active NPI

Jaimie Eva Wardinger, MD, MSC

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1104312180
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
25868 Issued in NV
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

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
64107MedicaidNY
1104312180MedicaidNV

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190215000618 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3577801679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25868NVMDNeonatal-Perinatal Medicine Physician
MD475719PAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.