Individual provider Active NPI

Isaac B. Tunnell, P.A.

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1164670634
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0160 Issued in NV
Practice address
6120 S Fort Apache Rd
Las Vegas, NV 89148-6702
Phone
(702) 948-8660
Fax
(702) 483-6663
NPI assigned
Sep 8, 2008
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0160 NV Primary

Addresses

Primary practice location

6120 S Fort Apache Rd
Las Vegas, NV 89148-6702

Mailing address

6120 S Fort Apache Rd
Las Vegas, NV 89148-6702
Phone (702) 948-8660

Other identifiers 1

IdentifierTypeStateIssuer
1164670634MedicaidNV

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
I20150916003608 NV Practitioner - Physician Assistant 8426183856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Pain Management and Rehabilitation LLCGroup PAC ID 0244390730, 3 clinicians

Practice addresses (Care Compare)

1358 Paseo Verde Pkwy
Henderson, NV 89012-5725
Phone (702) 982-7100

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
44.7
Promoting interoperability
100
Improvement activities
40
Cost
73.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0160NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
David D.Moon, D.O., LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: isaac.tunnell@221.securemail.prognocis.com

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, 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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1164670634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891486702",
            "telephone_number": "702-948-8660",
            "fax_number": "702-483-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891486702",
            "telephone_number": "702-948-8660",
            "fax_number": "702-483-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNNELL",
        "first_name": "ISAAC",
        "middle_name": "B.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "C0160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164670634",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.