Henderson Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

743038 Issued in NV

Legal business name

HENDERSON SURGERY CENTER

Practice address

1110 Wigwam Pkwy
Suite 105
Henderson, NV 89074-8185

Phone

(702) 921-6829

Fax

(702) 921-6828

NPI assigned

Aug 27, 2007

Organization subpart

No

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

Authorized official

Name

Rajat Sood, MDNPI 1962504126

Title

Managing Member

Phone

(702) 921-6829

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Robert M Yeh, MD

  • Gastroenterology Physician
  • Henderson, NV
  • NPI 1689856643

  I20041214000266

  Same enrollment

Listed as

Henderson Surgery CenterCCN 29C0001069

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

CLIA laboratory certificates

Tax ID family

Henderson Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Robert M Yeh MD PC

  • Gastroenterology Physician
  • Henderson, NV
  • NPI 1073573309
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rajat Sood, MD

  • Gastroenterology Physician
  • Henderson, NV
  • NPI 1962504126
  NPD (past) Authorized official
• Gilberto Juan De la Torre, M.D.

  • Specialist
  • Las Vegas, NV
  • NPI 1184650079
  NPD (past)
• Adedayo O Mokuolu, MD

  • Gastroenterology Physician
  • Henderson, NV
  • NPI 1467485409
  NPD (past)
• Arumugam Sivakumar, MD

  • Gastroenterology Physician
  • Henderson, NV
  • NPI 1578563102
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1174716708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 WIGWAM PKWY",
            "address_2": "SUITE 105",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748185",
            "telephone_number": "702-921-6829",
            "fax_number": "702-921-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 WIGWAM PKWY",
            "address_2": "SUITE 105",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748185",
            "telephone_number": "702-921-6829",
            "fax_number": "702-921-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "SOOD",
        "authorized_official_first_name": "RAJAT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-921-6829",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "743038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Senior Living
• Henderson Specialty RX LLC
• Henderson Specialty RX LLC
• Henderson Substance Abuse Treatment Center
• Henderson Sunrise Nielson PDC PLLC
• Henderson Vision Care LLC
• Chantel Henderson
• Christina Henderson
• Connor Henderson, DMD
• Richard Henderson, MD

• Ambulatory Surgical Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.