Individual provider Active NPI

Jose Parra, DO

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1295410017
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
SL2097 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4194
Phone
(702) 388-4000
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X DO4050 NV
Student in an Organized Health Care Education/Training Program 390200000X SL2097 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4194

Mailing address

620 Shadow LN
Las Vegas, NV 89106-4194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260430003877 NV Practitioner - General Practice 3577923168 Reassigns benefits to 1 organization
I20260612001065 AZ Practitioner - Internal Medicine 3577923168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1350 N Town Ctr Dr
Unit 1032
Las Vegas, NV 89144-0577

301 N Royal Oaks Blvd
Apt 3005
Franklin, TN 37067-4451

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO4050NVMDGeneral Practice Physician

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 4

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1295410017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRA",
        "first_name": "JOSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "DO4050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": "SL2097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.