Childrens Urology Associates, LLC

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

6402 Issued in NV

Legal business name

CHILDRENS UROLOGY ASSOCIATES, LLC

Practice address

6670 S Tenaya Way Ste 180
Las Vegas, NV 89113-1964

Phone

(702) 369-4999

Fax

(702) 369-2993

NPI assigned

Jun 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. George Ganesan, MDNPI 1457332538

Title

Partner

Phone

(702) 369-4999

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George S. Ganesan, M.D.

  • Specialist
  • Las Vegas, NV
  • NPI 1457332538
  Medicare reassignment Authorized official
• Jessica Tooredman Casey, MD

  • Pediatric Urology Physician
  • Las Vegas, NV
  • NPI 1396901765
  Medicare reassignment
• Waldo C. Feng, M.D.

  • Pediatric Urology Physician
  • Las Vegas, NV
  • NPI 1639169774
  Medicare reassignment
• James Chadwick Plaire, M.D.

  • Specialist
  • Las Vegas, NV
  • NPI 1104816248
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1134324668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6670 S TENAYA WAY STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131964",
            "telephone_number": "702-369-4999",
            "fax_number": "702-369-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 S TENAYA WAY STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131964",
            "telephone_number": "702-369-4999",
            "fax_number": "702-369-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "GANESAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-369-4999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "NV",
            "license": "6402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134324668",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LasVegas",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6670 S Tenaya Way Ste 180",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891131964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bobby Joe Childress
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• Pediatric Urology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatric Urology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.

Verify at the official NPI Registry.