Individual provider Active NPI

Alexander Keerthi Mylavarapu, M.D.

  • Internal Medicine Physician
  • Reno, NV
National Provider Identifier
1215319629
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17983 Issued in NV
Practice address
85 Kirman Ave Ste L1
Reno, NV 89502-1339
Phone
(775) 982-2828
Fax
(775) 982-2834
NPI assigned
Jun 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.067767 IL
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 17983 NV
Internal Medicine Physician 207R00000X 17983 NV Primary

Addresses

Primary practice location

85 Kirman Ave Ste L1
Reno, NV 89502-1339

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers 1

IdentifierTypeStateIssuer
17983OtherNVNEVADA STATE BOARD OF MEDICAL EXAMINERS

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
I20190325002538 NV Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 5193034197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nathan Adelson Hospice IncGroup PAC ID 6709820129, 10 clinicians

Practice addresses (Care Compare)

3150 N Tenaya Way
Suite 350
Las Vegas, NV 89128-0489
Phone (702) 733-0320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.067767ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Compassionate Care and Palliative Services Institute CurrentSince Jul 2, 2020 Accepting new patients
Trusted Primary Care CurrentSince Jul 2, 2020 Accepting new patients
Nathan Adelson Hospice Inc Current Accepting new patients

Locations

4141 University Center Dr
Las Vegas, NV 89119
Phone (702) 796-3162

3150 N Tenaya Way
Ste 350
Las Vegas, NV 89128
Phone (702) 243-6400

4131 University Center Dr
Las Vegas, NV 89119
Phone (702) 796-3112

2270 Commercial Dr
Ste B
Pahrump, NV 89048
Phone (702) 751-6700

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1215319629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 KIRMAN AVE STE L1",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021339",
            "telephone_number": "775-982-2828",
            "fax_number": "775-982-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLAVARAPU",
        "first_name": "ALEXANDER",
        "middle_name": "KEERTHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.067767",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NV",
            "license": "17983",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "17983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF MEDICAL EXAMINERS",
            "identifier": "17983",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.