Individual provider Active NPI

Sedale Boire, DO

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1346942067
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.OP.70124142 Issued in WA
Practice address
2880 N Tenaya Way
Las Vegas, NV 89128-0618
Phone
(702) 962-9551
NPI assigned
Mar 17, 2023
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO.OP.70124142 WA Primary

Addresses

Primary practice location

2880 N Tenaya Way
Las Vegas, NV 89128-0618

Mailing address

2880 N Tenaya Way
Las Vegas, NV 89128-0618
Phone (702) 962-9551

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
I20230619000958 NV Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 7618335902

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Zotec Way
Carmel, IN 46032-0052

PO Box
Los Angeles, CA 90084

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.OP.70124142WAMDEmergency Medicine Physician

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1346942067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280618",
            "telephone_number": "702-962-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280618",
            "telephone_number": "702-962-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOIRE",
        "first_name": "SEDALE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-17",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "DO.OP.70124142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.