Individual provider Active NPI

Yekaterina Anatolyevna Khronusova, MD

  • Hospitalist Physician
  • Las Vegas, NV
National Provider Identifier
1316949928
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
9662 Issued in NV
Practice address
1000 S Rainbow Blvd
Ste. a
Las Vegas, NV 89145-6231
Phone
(702) 464-8866
Fax
(702) 671-6851
NPI assigned
Aug 12, 2005
Last updated
Jun 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9662 NV
Hospitalist Physician 208M00000X 9662 NV Primary

Addresses

Primary practice location

1000 S Rainbow Blvd
Ste. a
Las Vegas, NV 89145-6231

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 507-2466

Other identifiers 1

IdentifierTypeStateIssuer
1316949928MedicaidNV

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
I20041104000850 NV Practitioner - Internal Medicine 0446213029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eid Nevada Critical Care PLLCGroup PAC ID 9537357793, 62 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9662NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eid Nevada Critical Care PLLC CurrentSince Aug 15, 2018 Accepting new patients
Intermountain Medical Holdings Nevada Inc Internal Medicine Past Accepting new patients
J Corey Brown MD Fremont Medical Center LTD Internal Medicine Past Accepting new patients
Yekaterina Khronusova PC Internal Medicine PastSince Oct 1, 2009 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

1801 W Olympic Blvd
#1270
Pasadena, CA 91199

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

6040 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 475-4007

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1316949928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-507-2466",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S RAINBOW BLVD",
            "address_2": "STE. A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-464-8866",
            "fax_number": "702-671-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHRONUSOVA",
        "first_name": "YEKATERINA",
        "middle_name": "ANATOLYEVNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9662",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "9662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316949928",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.