Individual provider Active NPI

Anthony Padilla, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1275356644
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0726 Issued in NV
Practice address
1669 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89012-3516
Phone
(702) 781-4800
Fax
(702) 664-6755
NPI assigned
Nov 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA0726 NV Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

1669 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89012-3516

Mailing address

3459 Saint Rose Pkwy Ste 120-481
Henderson, NV 89052-4601
Phone (702) 781-4800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514003450 NV Practitioner - Physician Assistant 9032637939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone (702) 946-7711

1669 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89012-3516
Phone (702) 781-4800

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5000

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

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 492-8000

Hospital & facility affiliations

  • North Vista Hospital Hospital, North Las Vegas, NV, CCN 290005
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA0726NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv P Amesur DO PC Multi-Specialty CurrentSince Apr 6, 2025 Accepting new patients

Locations

3459 Saint Rose Pkwy
#120481
Henderson, NV 89052

3459 Saint Rose Pkwy
Ste 120481
Henderson, NV 89052

1669 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89012
Phone (702) 781-4800

Organizations & group practices 2

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 3

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": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1275356644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 SAINT ROSE PKWY STE 120-481",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524601",
            "telephone_number": "702-781-4800",
            "fax_number": "702-664-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123516",
            "telephone_number": "702-781-4800",
            "fax_number": "702-664-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0726",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.