NPIMap

Individual provider Active NPI

Charissa Marie Rustia Carag, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1235570623
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125-062589 Issued in IL
Practice address
1294 S Jones Blvd
Las Vegas, NV 89146
Phone
(702) 877-1887
Fax
(702) 877-4536
NPI assigned
Jul 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 18297 NV
Internal Medicine Physician 207R00000X 125-062589 IL Primary

Addresses

Primary practice location

1294 S Jones Blvd
Las Vegas, NV 89146

Mailing address

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201216000440 NV Practitioner - Internal MedicinePractitioner - Nephrology 3072804483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology and Endocrine Associates IncGroup PAC ID 2961499322, 64 clinicians

Practice addresses (Care Compare)

8775 Deer Springs Way
Las Vegas, NV 89149-0416
Phone (702) 877-1887

Hospital & facility affiliations

  • 292543 Liberty Dialysis - Las Vegas (FMC) Dialysis facility, Las Vegas, NV, CCN 292543
  • 292544 West Sahara Dialysis (FMC) Dialysis facility, Las Vegas, NV, CCN 292544
  • 292527 Fire Mesa Dialysis (FMC) Dialysis facility, Las Vegas, NV, CCN 292527
  • South Rainbow Dialysis (FMC) Dialysis facility, Las Vegas, NV, CCN 292529
  • 292506 Northwest Las Vegas Dialysis (FMC) Dialysis facility, Las Vegas, NV, CCN 292506
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18297NVMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
125-062589ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology & Endocrine Associates Inc CurrentSince Oct 15, 2021 Accepting new patients
Nephrology & Endocrine Associates Inc Nephrology CurrentSince Oct 15, 2021 Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 310
Henderson, NV 89074
Phone (702) 565-6565

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1877

653 N Town Center Dr
Ste 70
Las Vegas, NV 89144
Phone (702) 360-6908

9280 W Sunset Rd
Ste 438
Las Vegas, NV 89148

8775 Deer Springs Way
Las Vegas, NV 89149
Phone (702) 395-2488

500 S Rancho Dr
Ste 12
Las Vegas, NV 89106
Phone (702) 877-1877

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

2065 N Las Vegas Blvd
North Las Vegas, NV 89030
Phone (702) 639-0469

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: charissa.carag@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1373673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1235570623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAG",
        "first_name": "CHARISSA MARIE",
        "middle_name": "RUSTIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-13",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "18297",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-062589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.