NPIMap

Organization Active NPI

Prestige Ultrasound, LLC

  • Radiology Clinic/Center
  • N Las Vegas, NV
National Provider Identifier
1194373522
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PRESTIGE ULTRASOUND, LLC
Practice address
3945 W Cheyenne Ave Ste 203
N Las Vegas, NV 89032-8902
Phone
(702) 423-0011
Fax
(702) 628-9996
NPI assigned
Aug 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Manuel Carranza
Title
Ceo
Phone
(702) 423-0011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

3945 W Cheyenne Ave Ste 203
N Las Vegas, NV 89032-8902

Mailing address

3945 W Cheyenne Ave Ste 203
N Las Vegas, NV 89032-8902
Phone (702) 423-0011

Other names 1

  • Prestige Ultrasound Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MANNYC@PRESTIGEULTRASOUND.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191008002110 NV Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0749511681 Practice locations: N Las Vegas, NV

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Prestige Ultrasound2 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.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1194373522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 W CHEYENNE AVE STE 203",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890328902",
            "telephone_number": "702-423-0011",
            "fax_number": "702-628-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 W CHEYENNE AVE STE 203",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890328902",
            "telephone_number": "702-423-0011",
            "fax_number": "702-628-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE ULTRASOUND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "CARRANZA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-423-0011"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MANNYC@PRESTIGEULTRASOUND.COM",
            "affiliation": "N",
            "address_1": "3945 W Cheyenne Ave Ste 203",
            "city": "N Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890328902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prestige Ultrasound",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Prestige Ultrasound",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in N Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.