Individual provider Active NPI

Neriy Izkhakov, MD, MPH

  • Endocrinology, Diabetes & Metabolism Physician
  • Las Vegas, NV
National Provider Identifier
1366974750
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
20052 Issued in NV
Practice address
5775 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-5627
Phone
(702) 874-8414
NPI assigned
Apr 3, 2017
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20052 NV
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 20052 NV Primary

Addresses

Primary practice location

5775 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-5627

Mailing address

5775 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-5627
Phone (702) 874-8414

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Izkhakov@EE-NV.direct.office.nextgen.com

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
I20220908001372 NV Practitioner - Endocrinology 6406127802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Izkhakov MD, PLLCGroup PAC ID 3971987090, 3 clinicians

Practice addresses (Care Compare)

5775 S Fort Apache Rd
Suite 120
Las Vegas, NV 89148-5627
Phone (702) 874-8414

9414 Del Webb Blvd
Las Vegas, NV 89134-8314
Phone (702) 874-8414

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Izkhakov MD, PLLC Endocrinology, Diabetes & Metabolism CurrentSince Aug 1, 2022 Accepting new patients

Locations

5775 S Fort Apache Rd
Ste 120
Las Vegas, NV 89148
Phone (702) 331-1654

9414 Del Webb Blvd
Las Vegas, NV 89134
Phone (702) 302-1460

Interoperability endpoints

  • Direct secure messaging: izkhakov@ee-nv.direct.office.nextgen.com

Organizations & group practices 1

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.

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1366974750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 S FORT APACHE RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485627",
            "telephone_number": "702-874-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 S FORT APACHE RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485627",
            "telephone_number": "702-874-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZKHAKOV",
        "first_name": "NERIY",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "20052",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NV",
            "license": "20052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Izkhakov@EE-NV.direct.office.nextgen.com",
            "affiliation": "N",
            "address_1": "5775 S Fort Apache Rd Ste 120",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891485627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.