Active NPI
Mac Neil Moresca, DPT
- Physical Therapist
- North Las Vegas, NV
National Provider Identifier
1215595038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4017
- Practice address
- 1550 West Craig Road
Suite 210
North Las Vegas, NV 89032 - Phone
- (702) 360-9142
- Fax
- (702) 649-0147
- NPI assigned
- Jun 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4017 | NV | Primary |
Addresses
Primary practice location
1550 West Craig Road
Suite 210
North Las Vegas, NV 89032
Mailing address
7688 Blue Diamond Road
Apt. 3129
Las Vegas, NV 89178
Phone (808) 237-0120
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1215595038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7688 BLUE DIAMOND ROAD",
"address_2": "APT. 3129",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89178",
"telephone_number": "808-237-0120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 WEST CRAIG ROAD",
"address_2": "SUITE 210",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "89032",
"telephone_number": "702-360-9142",
"fax_number": "702-649-0147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORESCA",
"first_name": "MAC NEIL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.