Individual provider Active NPI

Yaelene Diaz

  • Physical Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1306439799
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1306 Issued in NV
Practice address
3101 W Charleston Blvd
Las Vegas, NV 89102-1931
Phone
(702) 831-6670
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-1306 NV Primary

Addresses

Primary practice location

3101 W Charleston Blvd
Las Vegas, NV 89102-1931

Mailing address

3101 W Charleston Blvd
Las Vegas, NV 89102-1931
Phone (702) 831-6670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A-1306NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1306439799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021931",
            "telephone_number": "702-831-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021931",
            "telephone_number": "702-831-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "YAELENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.