Individual provider Active NPI

Wardon Adebayo Ojedapo, PA-C

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1164001392
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2416 Issued in NV
Practice address
3131 La Canada St Ste 140
Las Vegas, NV 89169-2579
Phone
(702) 304-5725
Fax
(702) 304-5725
NPI assigned
Apr 5, 2021
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA0499 NV
Medical Physician Assistant 363AM0700X PA2416 NV Primary

Addresses

Primary practice location

3131 La Canada St Ste 140
Las Vegas, NV 89169-2579

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

229 N Pecos Rd
Henderson, NV 89074-7363
Phone (702) 605-5650

Other identifiers 2

IdentifierTypeStateIssuer
PA2416OtherNVLICENSE
1164001392MedicaidNV

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
I20230216002850 NV Practitioner - Physician Assistant 1456723659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1397 S Loop Rd
Pahrump, NV 89048-4729
Phone (775) 727-5500

2880 N Tenaya Way
Suite 320
Las Vegas, NV 89128-0642
Phone (702) 862-8226

3131 La Canada St
Suite 200
Las Vegas, NV 89169-2579
Phone (702) 369-5582

4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone (702) 871-5005

6355 S Buffalo Dr
Las Vegas, NV 89113-2133
Phone (702) 479-4881

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0499NVMDMedical Physician Assistant
PA2416NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Mar 6, 2023 Accepting new patients
Healthcare Partners Medical Group (Coats), LTD. Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients

Locations

2880 N Tenaya Way
Ste 320
Las Vegas, NV 89128
Phone (702) 862-8226

3131 La Canada St
Ste 140
Las Vegas, NV 89169
Phone (702) 933-9400

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: wardonojedapo@hcpnv.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1164001392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692579",
            "telephone_number": "702-304-5725",
            "fax_number": "702-304-5725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 N Pecos Rd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890747363",
            "country_code": "US",
            "telephone_number": "702-605-5650",
            "fax_number": "702-605-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJEDAPO",
        "first_name": "WARDON",
        "middle_name": "ADEBAYO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA0499",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA2416",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164001392",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.