Organization Active NPI

Martinmd, Mavroidismd, Dhudshiamd, & Feikesmd, Cardiovascular Surgical

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Las Vegas, NV
National Provider Identifier
1275152522
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MARTINMD, MAVROIDISMD, DHUDSHIAMD, & FEIKESMD, CARDIOVASCULAR SURGICAL
Practice address
7488 W Sahara Ave
Las Vegas, NV 89117-2740
Phone
(702) 737-3808
NPI assigned
Apr 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Authorized official

Name
Jenna Hall
Title
Credentialing Specialist
Phone
(702) 719-8952

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

7488 W Sahara Ave
Las Vegas, NV 89117-2740

Mailing address

5320 S Rainbow Blvd Ste 282
Las Vegas, NV 89118-1896
Phone (702) 737-3808

Other practice location 1

5320 S Rainbow Blvd Ste 282
Las Vegas, NV 89118-1896
Phone (702) 737-3808

Other identifiers 1

IdentifierTypeStateIssuer
100503336MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Cardiovascular Surgery of Southern Nevada2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1275152522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 282",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181896",
            "telephone_number": "702-737-3808",
            "fax_number": "702-737-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7488 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172740",
            "telephone_number": "702-737-3808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5320 S Rainbow Blvd Ste 282",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181896",
            "country_code": "US",
            "telephone_number": "702-737-3808",
            "fax_number": "702-737-7364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARTINMD, MAVROIDISMD, DHUDSHIAMD, & FEIKESMD, CARDIOVASCULAR SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "702-719-8952"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503336",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.