Individual provider Active NPI

Steven John Kiss, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1134447584
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1214 Issued in NV
Practice address
3100 N Tenaya Way
North Tower; 4TH Floor
Las Vegas, NV 89128-0436
Phone
(702) 562-5726
NPI assigned
May 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1214 NV Primary

Addresses

Primary practice location

3100 N Tenaya Way
North Tower; 4TH Floor
Las Vegas, NV 89128-0436

Mailing address

3100 N Tenaya Way
North Tower; 4TH Floor
Las Vegas, NV 89128-0436
Phone (702) 562-5726

Other identifiers 2

IdentifierTypeStateIssuer
DJ481ZOtherMEDICARE PTAN
1134447584MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000396 NV Practitioner - Physician Assistant 5597899070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Mountainview Multispecialty Clinics LLCGroup PAC ID 1759469711, 64 clinicians

Practice addresses (Care Compare)

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (702) 255-5000

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1214NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innotiv Germin Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1134447584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N TENAYA WAY",
            "address_2": "NORTH TOWER; 4TH FLOOR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280436",
            "telephone_number": "702-562-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 N TENAYA WAY",
            "address_2": "NORTH TOWER; 4TH FLOOR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280436",
            "telephone_number": "702-562-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DJ481Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134447584",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.