Individual provider Active NPI

Adam Christopher Harkiewicz, P.A.

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1346585866
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 1397 Issued in NV
Practice address
861 Coronado Center Dr Ste 100
Henderson, NV 89052-3992
Phone
(702) 257-7546
Fax
(702) 870-4824
NPI assigned
Dec 10, 2012
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 1397 NV Primary
Medical Physician Assistant 363AM0700X PA 1397 NV
Dermatology Physician 207N00000X PA1397 NV

Addresses

Primary practice location

861 Coronado Center Dr Ste 100
Henderson, NV 89052-3992

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (407) 216-2691

Other identifiers 1

IdentifierTypeStateIssuer
PA1397OtherNVNEVADA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140725001533 NV Practitioner - Physician Assistant 6406072503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Nevada PCGroup PAC ID 0648492181, 4 clinicians

Practice addresses (Care Compare)

861 Coronado Ctr Dr
Suite 100
Henderson, NV 89052-3992
Phone (702) 257-7546

Merit-based Incentive Payment System (MIPS)

Final score
86.52 of 100Reported as group
Quality
89.02
Improvement activities
40
Cost
69.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5785AZMDMedical Physician Assistant
PA 1397NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jaldeep H Daulat DO Professional Corporation Dermatology Past Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1346585866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-216-2691",
            "fax_number": "702-307-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 CORONADO CENTER DR STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523992",
            "telephone_number": "702-257-7546",
            "fax_number": "702-870-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKIEWICZ",
        "first_name": "ADAM",
        "middle_name": "CHRISTOPHER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-10",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA 1397",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA 1397",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "PA1397",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA LICENSE",
            "identifier": "PA1397",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.