Active NPI
Concierge Care Physicians, LLP
- Internal Medicine Physician
- Henderson, NV
National Provider Identifier
1104850163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- CONCIERGE CARE PHYSICIANS, LLP
- Practice address
- 2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722 - Phone
- (702) 990-0622
- Fax
- (702) 938-1473
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Russell N. Neibaur, M.D.
- Title
- Physician
- Phone
- (702) 990-0622
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722
Mailing address
2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722
Phone (702) 990-0622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060918000208 | NV | Part B Supplier - Clinic/Group Practice | 3678578051 |
Receives reassigned benefits from 3 practitioners Practice locations: Henderson, NV |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2106943 | Concierge Care Physicians | Certificate of waiver | Jan 3, 2028 |
National Provider Directory
National Provider DirectoryLocations
861 Coronado Center Dr
Ste 103
Henderson, NV 89052
Phone (702) 998-0622
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Henderson, NV
- NPI 1821476797
Internal Medicine, NV
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722297600000",
"number": "1104850163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 W HORIZON RIDGE PKWY STE 150",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522722",
"telephone_number": "702-990-0622",
"fax_number": "702-938-1473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 W HORIZON RIDGE PKWY STE 150",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522722",
"telephone_number": "702-990-0622",
"fax_number": "702-938-1473"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONCIERGE CARE PHYSICIANS, LLP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A",
"authorized_official_last_name": "NEIBAUR",
"authorized_official_first_name": "RUSSELL",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "702-990-0622",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.