Individual provider Active NPI

Laveena Sullhan, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1316548431
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2394 Issued in NV
Practice address
540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone
(702) 877-5199
NPI assigned
Nov 4, 2020
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2394 NV Primary

Addresses

Primary practice location

540 N Nellis Blvd
Las Vegas, NV 89110-5368

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303001762 NV Practitioner - Physician Assistant 3577979343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medinix Medical Services Singh PLLCGroup PAC ID 3476955345, 24 clinicians

Practice addresses (Care Compare)

1321 S Rainbow Blvd
Suite 101
Las Vegas, NV 89146-9047
Phone (702) 476-2287

861 Coronado Ctr Dr
Suite 131
Henderson, NV 89052-3992
Phone (725) 245-6050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Jan 11, 2021 Accepting new patients
Apollocare Partners of Nevada, Inc. PastSince Jan 4, 2026 Accepting new patients

Locations

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

540 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-7424

Organizations & group practices 3

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": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1316548431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105368",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLHAN",
        "first_name": "LAVEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.