Active NPI
Kiddies Pal LLC
- Pediatrics Physician
- Las Vegas, NV
National Provider Identifier
1336665348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tal Minuskin, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100537177 | Medicaid | NV |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2131152 | Kiddies' Pal Pediatrics | Certificate of waiver | May 22, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & 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.