Individual provider Active NPI

Maureen McCormack, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1245260132
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10628 Issued in NV
Practice address
2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10628 NV Primary

Addresses

Primary practice location

2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 4

IdentifierTypeStateIssuer
1245260132MedicaidCA
200471100AMedicaidOK
P01168773OtherNVRR MEDICARE
100502381MedicaidNV

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
I20031119000098 NV Practitioner - Diagnostic Radiology 1951215334 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loyola University of Chicago, Stritch School of Medicine, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89106
Phone (702) 759-8600

Las Vegas, NV 89149
Phone (702) 759-8600

1397 S Loop Rd
Suite 100
Pahrump, NV 89048-4752
Phone (702) 759-8600

2811 W Horizon Ridge Pkwy
Henderson, NV 89052-4394
Phone (702) 759-8600

3025 S Rainbow Blvd
Las Vegas, NV 89146-6582
Phone (702) 759-8600

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (866) 722-1655

3920 S Eastern Ave
Suite 100
Las Vegas, NV 89119-5171
Phone (702) 759-8600

4880 Wynn Rd
Suite 100
Las Vegas, NV 89103-5406
Phone (702) 759-4600

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (702) 233-7571

6675 S Cimarron Rd
Las Vegas, NV 89113-2132
Phone (702) 759-8600

7200 Cathedral Rock Dr
Suite 230
Las Vegas, NV 89128-0440
Phone (702) 759-8600

Hospital & facility affiliations

  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10628NVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Specialists LTD Marasso-Miller Diagnostic Radiology CurrentSince Sep 20, 2025 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Nov 17, 2003 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 22, 2012 Accepting new patients
Diagnostic Health Centers of Texas, Limited Partnership Past Accepting new patients

Locations

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

3175 Saint Rose Pkwy
Ste 130
Henderson, NV 89052
Phone (702) 932-2740

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

7200 Cathedral Rock Dr
Las Vegas, NV 89128
Phone (702) 341-5444

2020 Palomino Ln
Las Vegas, NV 89106
Phone (702) 384-5210

4880 Wynn Rd
Ste 100
Las Vegas, NV 89103
Phone (702) 759-4600

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

6675 S Cimarron Rd
Las Vegas, NV 89113

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

7200 Cathedral Rock Dr
Ste 230
Las Vegas, NV 89128
Phone (702) 623-7568

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

31 N Nellis Blvd
Las Vegas, NV 89110

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

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

3920 S Eastern Ave
Las Vegas, NV 89119

1299 Bertha Howe Ave
Mesquite, NV 89027
Phone (702) 345-4270

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

1397 S Loop Rd
Ste 100
Pahrump, NV 89048

Interoperability endpoints

  • Direct secure messaging: mmccormack11538@direct.umcsn.com

Organizations & group practices 7

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 10

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1245260132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "MAUREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "10628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245260132",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200471100A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01168773",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502381",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.