Individual provider Active NPI

Elizabeth S Ehama, D.O.

  • Obstetrics Physician
  • Las Vegas, NV
National Provider Identifier
1205095403
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
DO2456 Issued in NV
Practice address
2011 Pinto LN
Las Vegas, NV 89106-4004
Phone
(702) 382-3200
Fax
(702) 382-3575
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 46723 CO
Gynecology Physician 207VG0400X DR-46723 CO
Obstetrics Physician 207VX0000X DO2456 NV Primary

Addresses

Primary practice location

2011 Pinto LN
Las Vegas, NV 89106-4004

Mailing address

2011 Pinto LN
Las Vegas, NV 89106-4004
Phone (702) 382-3200

Other identifiers 1

IdentifierTypeStateIssuer
03705854MedicaidCO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621001699 NV Practitioner - Obstetrics/Gynecology 7315095544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Iriye Medical Group PLLCGroup PAC ID 2163415910, 61 clinicians

Practice addresses (Care Compare)

2011 Pinto LN
Suite 200
Las Vegas, NV 89106-4007
Phone (702) 382-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
46723COMDObstetrics & Gynecology Physician
DR-46723COMDGynecology Physician
DO2456NVMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iriye Medical Group PLLC CurrentSince Jun 1, 2023 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

2011 Pinto Ln
Ste 200
Las Vegas, NV 89106
Phone (702) 382-3200

2011 Pinto Ln
Las Vegas, NV 89106
Phone (702) 382-3200

9970 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129
Phone (702) 978-8900

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.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1205095403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 PINTO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064004",
            "telephone_number": "702-382-3200",
            "fax_number": "702-382-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 PINTO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064004",
            "telephone_number": "702-382-3200",
            "fax_number": "702-382-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHAMA",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "46723",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CO",
            "license": "DR-46723",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NV",
            "license": "DO2456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03705854",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.