Individual provider Active NPI

Lior Mitnik

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1326780388
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO3910 Issued in NV
Practice address
1490 W Sunset Rd Ste 150
Henderson, NV 89014-6655
Phone
(702) 566-0333
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO3910 NV Primary

Addresses

Primary practice location

1490 W Sunset Rd Ste 150
Henderson, NV 89014-6655

Mailing address

1701 W Charleston Blvd Ste 670
Las Vegas, NV 89102-2343
Phone (702) 780-7588

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
I20220715001689 NV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8325429798

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3910NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Pediatrics PLLC Pediatrics CurrentSince Jul 9, 2025 Accepting new patients
Henderson Pediatrics, LLP Pediatrics PastSince Jul 9, 2025 Accepting new patients

Locations

1490 W Sunset Rd
Ste 150
Henderson, NV 89014
Phone (702) 566-0333

Organizations & group practices 2

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1326780388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 670",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022343",
            "telephone_number": "702-780-7588",
            "fax_number": "702-754-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 W SUNSET RD STE 150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146655",
            "telephone_number": "702-566-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITNIK",
        "first_name": "LIOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO3910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.