NPIMap

Organization Active NPI

Jurani LLC

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1295711372
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6166 Issued in NV
Legal business name
JURANI LLC
Practice address
633 N Decatur Blvd
Suite a
Las Vegas, NV 89107-1943
Phone
(702) 258-4900
Fax
(702) 258-5006
NPI assigned
Dec 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Dr. Paterno S Jurani, M.D.
Title
Physician/Owner
Phone
(702) 258-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 6166 NV Primary

Addresses

Primary practice location

633 N Decatur Blvd
Suite a
Las Vegas, NV 89107-1943

Mailing address

633 N Decatur Blvd
Suite a
Las Vegas, NV 89107-1943
Phone (702) 258-4900

Other identifiers 1

IdentifierTypeStateIssuer
002019515MedicaidNV

Other names 1

  • JURANI CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090611000387 NV Part B Supplier - Clinic/Group Practice 6406833888 Receives reassigned benefits from 5 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D0969875Jurani Clinic633 N Decatur Blvd Ste a, Las Vegas, NV 89107Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Locations

4180 S Sandhill Rd
Ste B7
Las Vegas, NV 89121
Phone (702) 454-5450

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1295711372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N DECATUR BLVD",
            "address_2": "SUITE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071943",
            "telephone_number": "702-258-4900",
            "fax_number": "702-258-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N DECATUR BLVD",
            "address_2": "SUITE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071943",
            "telephone_number": "702-258-4900",
            "fax_number": "702-258-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JURANI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "JURANI",
        "authorized_official_first_name": "PATERNO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "702-258-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "6166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019515",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JURANI CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.