Individual provider Active NPI

Laura Mabel Rodriguez, PA-C

  • Surgical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1356670665
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1194 Issued in NV
Practice address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA1194 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609

Mailing address

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Other practice location 1

2930 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5059
Phone (702) 263-9082

Other practice location 2

8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 227-2152

Other identifiers 2

IdentifierTypeStateIssuer
1356670665MedicaidNV
PA1194OtherNVNEVADA 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
I20100216000477 NV Practitioner - Physician Assistant 8325182231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

2231 W Charleston Blvd
Las Vegas, NV 89102-2254
Phone (702) 383-2663

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada CurrentSince Jan 20, 2025 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jan 20, 2025 Accepting new patients
Hand Surgery Specialists of Nevada Young LLP Past Accepting new patients
Black Mountain Orthopaedics Assc LLP Past Accepting new patients

Locations

1505 Wigwam Pkwy
Ste 330
Henderson, NV 89074
Phone (702) 878-0393

9321 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 216-9304

2231 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 383-2663

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2800 E Desert Inn Rd
Ste 100
Las Vegas, NV 89121
Phone (702) 294-7499

11860 Southern Highlands Pkwy
Ste 100
Las Vegas, NV 89141
Phone (702) 383-6230

4231 N Rancho Dr
Las Vegas, NV 89130
Phone (702) 383-3800

Interoperability endpoints

  • Direct secure messaging: rodlm@doclv.emadirect.md

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1356670665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2930 W Horizon Ridge Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890525059",
            "country_code": "US",
            "telephone_number": "702-263-9082",
            "fax_number": "702-263-9088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8205 W Warm Springs Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133646",
            "country_code": "US",
            "telephone_number": "702-227-2152",
            "fax_number": "702-252-0369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LAURA",
        "middle_name": "MABEL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356670665",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA LICENSE",
            "identifier": "PA1194",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.