Individual provider Active NPI

Alireza Habibi, D.O.

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1215354659
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO2221 Issued in NV
Practice address
10105 Banburry Cross Drive Suite 370
Las Vegas, NV 89144
Phone
(702) 260-4525
Fax
(702) 869-0133
NPI assigned
Mar 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO2221 NV Primary

Addresses

Primary practice location

10105 Banburry Cross Drive Suite 370
Las Vegas, NV 89144

Mailing address

10105 Banburry Cross Drive Suite 370
Las Vegas, NV 89144
Phone (702) 260-4525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2221NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Pediatrics, LLP Pediatrics Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Organizations & group practices 5

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1215354659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DRIVE SUITE 370",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89144",
            "telephone_number": "702-260-4525",
            "fax_number": "702-869-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DRIVE SUITE 370",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89144",
            "telephone_number": "702-260-4525",
            "fax_number": "702-869-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBI",
        "first_name": "ALIREZA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO2221",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.