NPIMap

Individual provider Active NPI

Mirela C Malevanov, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Henderson, NV
National Provider Identifier
1265480479
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
11177 Issued in NV
Practice address
715 Mall Ring Cir
Henderson, NV 89014-6665
Phone
(702) 483-6200
Fax
(702) 483-6202
NPI assigned
May 4, 2006
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11177 NV
Pulmonary Disease Physician 207RP1001X 11177 NV
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 11177 NV Primary

Addresses

Primary practice location

715 Mall Ring Cir
Henderson, NV 89014-6665

Mailing address

715 Mall Ring Cir
Henderson, NV 89014-6665
Phone (702) 483-6200

Other identifiers 2

IdentifierTypeStateIssuer
CM717ZOtherNVNVCC-PTAN
V102803OtherNVPTAN

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
I20041221000228 NV Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4284692450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Qureshi Al-Owir PLLCGroup PAC ID 4183763592, 18 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (702) 388-4000

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (702) 233-7572

6900 N Durango Dr
Las Vegas, NV 89149-4409
Phone (702) 835-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.71 of 100Reported as group
Quality
22.52
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11177NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qureshi Al-Owir PLLC Critical Care Medicine CurrentSince Nov 1, 2009 Accepting new patients
Tri City Medical Hospitalists LLC Internal Medicine Past Accepting new patients
Tri City Medical Associates PC Internal Medicine Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

715 Mall Ring Cir
Henderson, NV 89014
Phone (702) 483-6200

715 Mall Ring Cir
Ste 202
Henderson, NV 89014
Phone (702) 483-5092

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1265480479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MALL RING CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146665",
            "telephone_number": "702-483-6200",
            "fax_number": "702-483-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MALL RING CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146665",
            "telephone_number": "702-483-6200",
            "fax_number": "702-483-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEVANOV",
        "first_name": "MIRELA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11177",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NV",
            "license": "11177",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NV",
            "license": "11177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVCC-PTAN",
            "identifier": "CM717Z",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V102803",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.