Individual provider Active NPI

Matthew Nolan Fouse, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Las Vegas, NV
National Provider Identifier
1306898119
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
12206 Issued in NV
Practice address
2800 E Desert Inn Rd
Suite #100
Las Vegas, NV 89121-3608
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
May 17, 2006
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 12206 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd
Suite #100
Las Vegas, NV 89121-3608

Mailing address

PO Box 50509
Henderson, NV 89016-0509
Phone (702) 731-1616

Other practice location 1

8402 Centennial Pkwy
Las Vegas, NV 89149-4792
Phone (702) 869-3486

Other practice location 2

8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 227-2152

Other identifiers 4

IdentifierTypeStateIssuer
NV4937OtherBC/BS
7417894OtherAETNA
103890OtherMEDICARE PTAN
100512161MedicaidNV

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
I20070621000245 NV Practitioner - Orthopedic Surgery 7810990413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Orthopaedic Center, LTD. Orthopaedic Surgery CurrentSince Aug 13, 2007 Accepting new patients
The Sports Clinic Orthopaedic Medical Associates, Inc. Orthopaedic Surgery PastSince Aug 1, 1991 Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Desert Orthopaedic Center, LTD. Orthopaedic Surgery Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Desert Orthopaedic Billing LLC Orthopaedic Surgery Past Accepting new patients

Locations

2930 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 263-9082

2800 E Desert Inn Rd
Ste 100
Las Vegas, NV 89121
Phone (702) 294-7499

8205 W Warm Springs Rd
Ste 250
Las Vegas, NV 89113
Phone (702) 227-2152

8402 Centennial Pkwy
Las Vegas, NV 89149
Phone (702) 869-3486

8689 W Charleston Blvd
Ste 105
Las Vegas, NV 89117
Phone (702) 304-5900

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1306898119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50509",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890160509",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD",
            "address_2": "SUITE #100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213608",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494792",
            "country_code": "US",
            "telephone_number": "702-869-3486",
            "fax_number": "702-869-3542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8205 W Warm Springs Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133646",
            "country_code": "US",
            "telephone_number": "702-227-2152",
            "fax_number": "702-252-0369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUSE",
        "first_name": "MATTHEW",
        "middle_name": "NOLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NV",
            "license": "12206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "NV4937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7417894",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "103890",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100512161",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.