Individual provider Active NPI

Benjamin Arceo Gallegos Jr.

  • Home Health Aide
  • Las Vegas, NV
National Provider Identifier
1326613811
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
840851 Issued in NV
Practice address
4850 W Flamingo Rd Ste 25
Las Vegas, NV 89103-3707
Phone
(702) 871-9917
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 840851 NV Primary

Addresses

Primary practice location

4850 W Flamingo Rd Ste 25
Las Vegas, NV 89103-3707

Mailing address

476 Accelerando Way
Henderson, NV 89011-2675
Phone (949) 295-3368

Other identifiers 1

IdentifierTypeStateIssuer
840851OtherNVSTATE OF BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
840851NVMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1326613811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 ACCELERANDO WAY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112675",
            "telephone_number": "949-295-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W FLAMINGO RD STE 25",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891033707",
            "telephone_number": "702-871-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "BENJAMIN",
        "middle_name": "ARCEO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NV",
            "license": "840851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF BOARD OF NURSING",
            "identifier": "840851",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.