Individual provider Active NPI

Ian Jacob Arcala Fallejo, RN

  • Critical Care Medicine Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1346144581
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
855924 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4194
Phone
(702) 388-4000
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 855924 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4194

Mailing address

620 Shadow LN
Las Vegas, NV 89106-4194

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1346144581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLEJO",
        "first_name": "IAN JACOB",
        "middle_name": "ARCALA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NV",
            "license": "855924",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.