Organization Active NPI

Hirata Pediatrics LLC

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1124240817
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HIRATA PEDIATRICS LLC
Practice address
3196 S Maryland Pkwy Ste 208
Las Vegas, NV 89109-2313
Phone
(702) 796-1820
Fax
(702) 796-3938
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Keilly Rubio Avalos
Title
Biller
Phone
(702) 796-1820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3196 S Maryland Pkwy Ste 208
Las Vegas, NV 89109-2313

Mailing address

3196 S Maryland Pkwy Ste 208
Las Vegas, NV 89109-2313
Phone (702) 796-1820

Other identifiers 1

IdentifierTypeStateIssuer
100509805MedicaidNV

Other names 2

  • La Canada Pediatrics Doing business as
  • LaCanada Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D0969874La Canada Pediatrics3196 S Maryland Pkwy Ste 208, Las Vegas, NV 89109Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Locations

3006 S Maryland Pkwy
Ste 530
Las Vegas, NV 89109
Phone (702) 796-1820

3131 La Canada St
Ste 231
Las Vegas, NV 89169
Phone (702) 796-1820

3196 S Maryland Pkwy
Ste 208
Las Vegas, NV 89109
Phone (702) 796-1820

Practitioners & affiliated clinicians

Practitioners 4

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1124240817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092313",
            "telephone_number": "702-796-1820",
            "fax_number": "702-796-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092313",
            "telephone_number": "702-796-1820",
            "fax_number": "702-796-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIRATA PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "RUBIO AVALOS",
        "authorized_official_first_name": "KEILLY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "702-796-1820"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509805",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Canada Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LaCanada Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LaCanada Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.