Individual provider Active NPI

Craig Tadashi Nakamura, MD

  • Pediatric Pulmonology Physician
  • Las Vegas, NV
National Provider Identifier
1295721918
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
9572 Issued in NV
Practice address
3196 S Maryland Pkwy Ste 209
Las Vegas, NV 89109-2313
Phone
(702) 598-4411
Fax
(702) 598-1988
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 9572 NV Primary

Addresses

Primary practice location

3196 S Maryland Pkwy Ste 209
Las Vegas, NV 89109-2313

Mailing address

3196 S Maryland Pkwy Ste 209
Las Vegas, NV 89109-2313
Phone (702) 598-4411

Other identifiers 1

IdentifierTypeStateIssuer
002018611MedicaidNV

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
I20080102000404 NV Practitioner - Pediatric MedicinePractitioner - Pulmonary DiseasePractitioner - Other (Physician) 2062511272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
University of Hawaii John a. Burns School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Lung SpecialistsGroup PAC ID 5991782971, 4 clinicians

Practice addresses (Care Compare)

3196 S Maryland Pkwy
Suite 209
Las Vegas, NV 89109-2313
Phone (702) 598-4411

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Lung Specialists Pediatric Pulmonology CurrentSince Jan 1, 2001 Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

3196 S Maryland Pkwy
Ste 400
Las Vegas, NV 89109
Phone (702) 598-4411

3006 S Maryland Pkwy
Ste 315
Las Vegas, NV 89109
Phone (702) 992-6868

3820 Meadows Ln
Las Vegas, NV 89107
Phone (702) 598-4411

3196 S Maryland Pkwy
Ste 209
Las Vegas, NV 89109
Phone (702) 598-4411

Interoperability endpoints

  • Direct secure messaging: cnakamura6253@direct.umcsn.com

Organizations & group practices 5

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1295721918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092313",
            "telephone_number": "702-598-4411",
            "fax_number": "702-598-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092313",
            "telephone_number": "702-598-4411",
            "fax_number": "702-598-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "CRAIG",
        "middle_name": "TADASHI",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NV",
            "license": "9572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018611",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.