Active NPI
Justin Puopolo, D.O.
- Diagnostic Radiology Physician
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- DO1947
- Practice address
- 5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872 - Phone
- (702) 477-0772
- NPI assigned
- May 18, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | DO1947 | NV | Primary |
Addresses
Primary practice location
5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872
Mailing address
PO Box 30077
Salt Lake City, UT 84130-0077
Phone (702) 477-0772
Other practice location 1
5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-1000
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
102 E Lake Mead Pkwy
Henderson, NV 89015-5575
Phone (702) 616-4585
1155 Raiders Way
Henderson, NV 89052-4670
Phone (702) 963-7000
1299 Bertha Howe Ave
Mesquite, NV 89027-7500
Phone (702) 346-8040
1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone (702) 657-5507
1941 Jefferson St
Suite 105
North Las Vegas, NV 89030-6960
Phone (702) 228-0031
2628 W Charleston Blvd
Las Vegas, NV 89102-2176
Phone (702) 228-0031
3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5585
5495 S Rainbow Blvd
Suite 101
Las Vegas, NV 89118-1872
Phone (702) 228-0031
8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 616-5000
8551 W Lake Mead Blvd
Suite 150
Las Vegas, NV 89128-7649
Phone (702) 228-0031
901 Adams Blvd
Boulder City, NV 89005-2213
Phone (702) 293-4111
Hospital & facility affiliations
- Saint Rose Dominican Hospitals - Siena Campus
- Henderson Hospital
- Saint Rose Dominican Hospitals - San Martin Campus
- West Henderson Hospital
- Mesa View Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13160 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J Paul Wiesner & Associates Chartered | Diagnostic Radiology | Current | Accepting new patients |
| Pueblo Medical Imaging, LLC | Diagnostic Radiology | Current | Accepting new patients |
Locations
102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622
100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074
Phone (702) 990-7417
8551 W Lake Mead Blvd
Ste 150
Las Vegas, NV 89128
Phone (702) 683-5516
2628 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 644-0500
5495 S Rainbow Blvd
Ste 101
Las Vegas, NV 89118
Phone (702) 214-9729
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.
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1487606026
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1952353591
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1528101284
-
- General Acute Care Hospital
- Henderson, NV
- NPI 1770626426
-
- General Acute Care Hospital
- Henderson, NV
- NPI 1003281452
-
- Critical Access Hospital
- Mesquite, NV
- NPI 1275588782
-
- General Acute Care Hospital
- Henderson, NV
- NPI 1962181172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508457600000",
"number": "1154556314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30077",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300077",
"telephone_number": "702-477-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5495 S RAINBOW BLVD STE 101",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891181872",
"telephone_number": "702-477-0772"
}
],
"practiceLocations": [
{
"address_1": "5100 W Broad St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432281607",
"country_code": "US",
"telephone_number": "614-544-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PUOPOLO",
"first_name": "JUSTIN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-18",
"last_updated": "2017-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NV",
"license": "DO1947",
"primary": true
}
],
"identifiers": [],
"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 Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.