Individual provider Active NPI

Ali Shehata, D.O.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1205997665
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2829 Issued in NV
Practice address
4560 S Eastern Ave Ste 20
Las Vegas, NV 89119-6182
Phone
(888) 693-6258
Fax
(407) 550-6393
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO2829 NV Primary

Addresses

Primary practice location

4560 S Eastern Ave Ste 20
Las Vegas, NV 89119-6182

Mailing address

4560 S Eastern Ave Ste 20
Las Vegas, NV 89119-6182
Phone (888) 693-6258

Other identifiers 2

IdentifierTypeStateIssuer
1205997665MedicaidNV
DO2829OtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NV, WI4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20070221000103 MN Practitioner - Emergency MedicinePractitioner - Family Practice 6002890647 Reassigns benefits to 7 organizations
I20201120000906 NV Practitioner - Family Practice 6002890647 Reassigns benefits to 5 organizations
I20240205001354 MN Practitioner - Family Practice 6002890647 Reassigns benefits to 3 organizations
I20240823002651 WI Practitioner - Family Practice 6002890647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Mt Grant General HospitalGroup PAC ID 1951290337, shared by 4 NPIs, 15 clinicians
United Hospital District IncGroup PAC ID 6204158884, 50 clinicians

Practice addresses (Care Compare)

200 S a St
Hawthorne, NV 89415-1510
Phone (775) 945-2461

515 S Moore St
Blue Earth, MN 56013-2158
Phone (507) 526-7388

Hospital & facility affiliations

  • Chippewa County Hospital Hospital, Montevideo, MN, CCN 241325
  • United Hospital District Hospital, Blue Earth, MN, CCN 241369
  • Sanford Luverne Medical Center Hospital, Luverne, MN, CCN 241371
  • Mount Grant General Hospital Hospital, Hawthorne, NV, CCN 291300
  • Windom Area Health Hospital, Windom, MN, CCN 241332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2975WIMDClinical Social Worker
DO2829NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Sanford Health Network Current Accepting new patients
Cook County Hospital District Current Accepting new patients
Prairie Du Chien Memorial Hospital Assoc Inc Family Medicine CurrentSince Jun 23, 2024 Accepting new patients
United Hospital District Inc. Family Medicine CurrentSince May 9, 2023 Accepting new patients
Sanford Health Network Family Medicine CurrentSince May 8, 2023 Accepting new patients
Windom Area Hospital CurrentSince Apr 7, 2023 Accepting new patients
Pershing General Hospital CurrentSince Jul 14, 2023 Accepting new patients
Mt Grant General Hospital CurrentSince Nov 1, 2023 Accepting new patients
CCM Health Current Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Jun 23, 2024 Accepting new patients
Windom Area Hospital CurrentSince Apr 7, 2023 Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Sanford Health Network CurrentSince May 8, 2023 Accepting new patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Sanford Health Network Current Accepting new patients
Mt Grant General Hospital CurrentSince Nov 1, 2023 Accepting new patients
Windom Area Hospital CurrentSince Jan 12, 2026 Accepting new patients
Pershing General Hospital CurrentSince Jul 14, 2023 Accepting new patients
Ely-Bloomenson Community Hospital Current Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Fairfield Memorial Hospital Past Accepting new patients
Allendale County Hospital Board Past Accepting new patients
Williamsburg Regional Hospital Past Accepting new patients
SCB Inc Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Pee Dee Foot Center, PA PastSince Jul 25, 1999 Accepting new patients
Desert Springs Hospital Past Accepting new patients
United Hospital District Inc. PastSince Oct 31, 2021 Accepting new patients

Locations

515 S Moore St
Blue Earth, MN 56013
Phone (507) 526-3273

328 W Conan St
Ely, MN 55731
Phone (218) 365-3271

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

1430 North Hwy
Jackson, MN 56143
Phone (507) 847-2200

1601 Sioux Valley Dr
Luverne, MN 56156
Phone (507) 283-4476

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

2042 Juniper Ave
Slayton, MN 56172
Phone (507) 836-1227

249 5th St E
Tracy, MN 56175
Phone (507) 629-3520

2150 Hospital Dr
Windom, MN 56101
Phone (507) 831-0618

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

4275 Burnham Ave
Ste 340
Las Vegas, NV 89119
Phone (702) 734-6363

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

Interoperability endpoints

  • Direct secure messaging: ali.shehata.1@11938.direct.athenahealth.com
  • Direct secure messaging: ashehata877602@direct.gundersenhealth.org
  • Direct secure messaging: ashehata1778@direct.centracare.com
  • Direct secure messaging: ashehata877602@direct.emplifyhealth.org

Organizations & group practices 31

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.

View all 31

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1205997665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 S EASTERN AVE STE 20",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196182",
            "telephone_number": "888-693-6258",
            "fax_number": "407-550-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 S EASTERN AVE STE 20",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196182",
            "telephone_number": "888-693-6258",
            "fax_number": "407-550-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHATA",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205997665",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DO2829",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.