Individual provider Active NPI

Juan Pablo Quevedo Raygoza, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1275160392
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23687 Issued in NV
Practice address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone
(702) 952-9171
Fax
(702) 671-6851
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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 LL3477 NV
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 23687 NV Primary

Addresses

Primary practice location

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

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
I20230724001449 NV Practitioner - Internal Medicine 6709200066 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Feb 3, 2025 Accepting new patients
Intermountain Medical Holdings Nevada Inc Internal Medicine CurrentSince Feb 3, 2025 Accepting new patients
Nevada Acute Medical Services-Scherr 1 PC CurrentSince Jul 7, 2023 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

1250 S Valley View Blvd
Las Vegas, NV 89102
Phone (702) 259-3570

6355 S Buffalo Dr
Las Vegas, NV 89113
Phone (702) 952-9171

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

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1275160392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-952-9171",
            "fax_number": "702-671-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO RAYGOZA",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "LL3477",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "23687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.