Organization Active NPI

Husameddin Elmesallati MD PLLC

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1124596978
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HUSAMEDDIN ELMESALLATI MD PLLC
Practice address
3022 S Durango Dr Ste 100
Las Vegas, NV 89117-4440
Phone
(702) 256-3637
NPI assigned
Nov 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Husameddin Elmesallati, MDNPI 1073775110
Title
Owner
Phone
(443) 789-4665

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3022 S Durango Dr Ste 100
Las Vegas, NV 89117-4440

Mailing address

PO Box 50224
Henderson, NV 89016-0224
Phone (443) 789-4665

Other identifiers 1

IdentifierTypeStateIssuer
1073775110MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190104002909 NV Part B Supplier - Clinic/Group Practice 5496091886 Receives reassigned benefits from 1 practitioner
Practice locations: Henderson, NV; Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3455 Pecos McLeod
Las Vegas, NV 89121
Phone (702) 790-6400

Practitioners & affiliated clinicians

Practitioners 1

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": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1124596978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50224",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890160224",
            "telephone_number": "443-789-4665",
            "fax_number": "702-941-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174440",
            "telephone_number": "702-256-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSAMEDDIN ELMESALLATI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "ELMESALLATI",
        "authorized_official_first_name": "HUSAMEDDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-789-4665",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073775110",
            "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 Apr 17, 2025; 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.