Individual provider Active NPI

Michael Grant Bryan, MD

  • Dermatology Physician
  • Las Vegas, NV
National Provider Identifier
1356443196
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
11335 Issued in NV
Practice address
4488 S Pecos Rd
Las Vegas, NV 89121-5030
Phone
(702) 436-1001
Fax
(702) 436-7999
NPI assigned
Sep 2, 2006
Last updated
Jan 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 11335 NV Primary

Addresses

Primary practice location

4488 S Pecos Rd
Las Vegas, NV 89121-5030

Mailing address

PO Box 12060
Las Vegas, NV 89112-0060
Phone (702) 360-2100

Other identifiers 1

IdentifierTypeStateIssuer
P01115811OtherNVRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050613001219 NV Practitioner - Dermatology 4486698206 Reassigns benefits to 1 organization
I20231127003078 UT Practitioner - Dermatology 4486698206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

2650 N Tenaya Way
Suite 208
Las Vegas, NV 89128-1104
Phone (702) 360-2100

400 N Stephanie St
Suite 400
Henderson, NV 89014-6692
Phone (702) 990-4800

653 N Town Ctr Dr
Suite 214
Las Vegas, NV 89144-0516
Phone (702) 255-7924

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as individual
Quality
98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions897
Removal of skin cancer60
Skin biopsy118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11335NVMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Dermatology CurrentSince Mar 1, 2010 Accepting new patients
Utah Valley Dermatology PC Dermatology CurrentSince Nov 15, 2023 Accepting new patients
J Robert West, M.D., Inc Dermatology CurrentSince Mar 1, 2010 Accepting new patients
J. Robert West, M.D., Inc Dermatology Past Accepting new patients
Dignity Health Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

400 N Stephanie St
Ste 400
Henderson, NV 89014
Phone (702) 933-0225

880 Seven Hills Dr
Ste 260
Henderson, NV 89052
Phone (702) 382-3200

1250 S Buffalo Dr
Ste 170
Las Vegas, NV 89117
Phone (702) 255-7924

2650 N Tenaya Way
Ste 208
Las Vegas, NV 89128
Phone (702) 360-2100

3010 W Charleston Blvd
Las Vegas, NV 89102

3010 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 933-0225

3010 W Charleston Blvd
Ste 200
Las Vegas, NV 89102

4488 S Pecos Rd
Las Vegas, NV 89121
Phone (702) 258-1001

630 S Rancho Dr
Ste E
Las Vegas, NV 89106
Phone (702) 258-1001

653 N Town Center Dr
Ste 214
Las Vegas, NV 89144
Phone (702) 248-8989

7220 S Cimarron Rd
Ste 200
Las Vegas, NV 89113
Phone (702) 463-0800

8205 W Warm Springs Rd
Ste 190
Las Vegas, NV 89113
Phone (702) 588-6730

9780 W Skye Canyon Park Dr
Ste 100
Las Vegas, NV 89166
Phone (702) 589-3100

3300 N 1200 W
Ste 200
Lehi, UT 84043

680 E Main St
Lehi, UT 84043
Phone (801) 766-0606

680 E Main St
Ste 202
Lehi, UT 84043
Phone (801) 331-8554

62 E Thrive Dr
Ste 220
Saratoga Springs, UT 84045
Phone (435) 218-8185

Organizations & group practices 7

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1356443196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12060",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891120060",
            "telephone_number": "702-360-2100",
            "fax_number": "909-557-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215030",
            "telephone_number": "702-436-1001",
            "fax_number": "702-436-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "MICHAEL",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "11335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01115811",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.