Justine Ibanez Ipac, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2701 N Tenaya Way Ste 290
Las Vegas, NV 89128-1406

Phone

(702) 420-2163

Fax

(702) 420-2930

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

University of Nevada School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Medical Associates of Nevada PCGroup PAC ID 0648492181, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Leavitt Medical Associates of Nevada PC

  • Dermatology Physician
  • Henderson, NV
  • NPI 1124436480
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1306417647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N TENAYA WAY STE 290",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281406",
            "telephone_number": "702-420-2163",
            "fax_number": "702-420-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N TENAYA WAY STE 290",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281406",
            "telephone_number": "702-420-2163",
            "fax_number": "702-420-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPAC",
        "first_name": "JUSTINE",
        "middle_name": "IBANEZ",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chun Hei Ip, DMD
• Courtney Ip
• Kwong Shun Ip
• Randy James Ip, D.O.
• Vincent Ip, DDS
• Ipc Healthcare Services of Nevada PC
• Ipc Healthcare Services of Nevada, Inc
• Ipc Hospitalists
• Juan Ipina
• Ipmed LLC

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.