Carlos Espina Ezpeleta, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6958 Issued in NV

Practice address

61 N. Nellis Blvd.
Las Vegas, NV 89110

Phone

(702) 383-6250

Fax

(702) 459-8497

NPI assigned

Jul 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• West Texas Internal Medicine Clinic

  dba Jim J. Guerra M.D.

  • Specialist
  • Fort Worth, TX
  • NPI 1215013511
  NPD (past)

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1265432793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W. CHARLESTON BLVD. STE. 508",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-383-2688",
            "fax_number": "702-671-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 N. NELLIS BLVD.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "702-383-6250",
            "fax_number": "702-459-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZPELETA",
        "first_name": "CARLOS",
        "middle_name": "ESPINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3534",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200140601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110059773",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0006127113",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084623",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlos Javier Ezeta, M.S., ME.D.
• Rutu S Ezhuthachan, MD
• Jude C Ezidiegwu, B.PHARM
• Patricia-Mae Ezidiegwu, RN
• Isis Ezikpe
• Karla Ezpeleta
• Heman Ezra, PT
• F Faris MD LTD (Frontier Gastroenterology Center)
• F. Akioyame Medical Consultant Inc (Vip Primary Care)
• F. Victor Rueckl Dermatology, PLLC (Lakes Dermatology)

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.