Individual provider Active NPI

Jennifer C Raroque, M.D.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1316995434
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11178 Issued in NV
Practice address
10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982
Phone
(702) 380-1888
Fax
(702) 463-1507
NPI assigned
May 4, 2006
Last updated
Aug 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11178 NV Primary

Addresses

Primary practice location

10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982

Mailing address

10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982
Phone (702) 380-1888

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
I20041222000110 NV Practitioner - Internal Medicine 7315905304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
61.15 of 100Reported as group
Quality
36.67
Improvement activities
40
Cost
61.8

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Family Medicine CurrentSince Dec 18, 2010 Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Dec 18, 2010 Accepting new patients
Henderson Hospital Past Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1316995434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE STE A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-380-1888",
            "fax_number": "702-463-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE STE A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-380-1888",
            "fax_number": "702-463-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAROQUE",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.