Individual provider Active NPI

Melissa S Tuck-White, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1306973979
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23624 Issued in NV
Practice address
410 S Rampart Blvd Ste 420
Las Vegas, NV 89145-5749
Phone
(702) 240-4200
Fax
(702) 548-4253
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M9065 TX
Family Medicine Physician 207Q00000X 10309A WY
Family Medicine Physician 207Q00000X DR.0057992 CO
Family Medicine Physician 207Q00000X 23624 NV Primary

Addresses

Primary practice location

410 S Rampart Blvd Ste 420
Las Vegas, NV 89145-5749

Mailing address

5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Phone (307) 634-1311

Other identifiers 1

IdentifierTypeStateIssuer
192649501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250429002229 GA Practitioner - Family Practice 8123105004 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23624NVMDPharmacist
DR.0057992COMDFamily Medicine Physician
M9065TXMDFamily Medicine Physician
10309AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galileo Medical Group Ga, P.C. Family Medicine CurrentSince Mar 13, 2025 Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1306973979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 POWDERHOUSE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094800",
            "telephone_number": "307-634-1311",
            "fax_number": "307-634-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S RAMPART BLVD STE 420",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891455749",
            "telephone_number": "702-240-4200",
            "fax_number": "702-548-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK-WHITE",
        "first_name": "MELISSA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9065",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "10309A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0057992",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "23624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192649501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.