NPIMap

Organization Active NPI

Open Sided MRI of Las Vegas, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1205857232
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
NV19961017227 Issued in NV
Legal business name
OPEN SIDED MRI OF LAS VEGAS, LLC
Practice address
600 S Rancho Dr Ste 101
Las Vegas, NV 89106-4806
Phone
(702) 932-2740
Fax
(702) 932-2739
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
John Steven Platusic
Title
Coo
Phone
(804) 363-1007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X NV19961017227 NV Primary

Addresses

Primary practice location

600 S Rancho Dr Ste 101
Las Vegas, NV 89106-4806

Mailing address

600 S Rancho Dr Ste 101
Las Vegas, NV 89106-4806
Phone (702) 932-2740

Other identifiers 1

IdentifierTypeStateIssuer
002702170MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040810000496 NV Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5698662971 Practice locations: 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

Locations

630 S Rancho Dr
Ste G
Las Vegas, NV 89106
Phone (702) 932-2740

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1205857232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S RANCHO DR STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064806",
            "telephone_number": "702-932-2740",
            "fax_number": "702-932-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S RANCHO DR STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064806",
            "telephone_number": "702-932-2740",
            "fax_number": "702-932-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SIDED MRI OF LAS VEGAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2021-04-08",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "PLATUSIC",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "804-363-1007"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NV",
            "license": "NV19961017227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002702170",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.