Organization Active NPI

Kiddies Pal LLC

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1336665348
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDDIES PAL LLC
Practice address
851 S Rampart Blvd Ste 130
Las Vegas, NV 89145-4884
Phone
(702) 823-1333
Fax
(702) 823-1190
NPI assigned
Aug 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Tal Minuskin, MDNPI 1508062506
Title
Owner/Ceo
Phone
(702) 823-1333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

851 S Rampart Blvd Ste 130
Las Vegas, NV 89145-4884

Mailing address

851 S Rampart Blvd Ste 130
Las Vegas, NV 89145-4884
Phone (702) 823-1333

Other identifiers 1

IdentifierTypeStateIssuer
100537177MedicaidNV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2131152Kiddies' Pal Pediatrics851 S Rampart Blvd Ste 130, Las Vegas, NV 89145Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1336665348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S RAMPART BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454884",
            "telephone_number": "702-823-1333",
            "fax_number": "702-823-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S RAMPART BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454884",
            "telephone_number": "702-823-1333",
            "fax_number": "702-823-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDDIES PAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MINUSKIN",
        "authorized_official_first_name": "TAL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "702-823-1333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100537177",
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.