NPIMap

Individual provider Active NPI

Jimmy John N Novero, M.D.

  • Neurology Physician
  • Las Vegas, NV
National Provider Identifier
1376502880
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
12848 Issued in NV
Practice address
3150 N Tenaya Way
Suite 555
Las Vegas, NV 89128-0443
Phone
(702) 685-8392
Fax
(702) 475-5219
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 12848 NV Primary

Addresses

Primary practice location

3150 N Tenaya Way
Suite 555
Las Vegas, NV 89128-0443

Mailing address

3150 N Tenaya Way
Suite 555
Las Vegas, NV 89128-0443
Phone (702) 685-8392

Other identifiers 1

IdentifierTypeStateIssuer
1376502880MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090508000082 NV Practitioner - Neurology 4385792928 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12848NVMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Apr 1, 2024 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Community Memorial Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Syracuse Neurology, PLLC Neurology Past Accepting new patients
Dignity Health Past Accepting new patients
Atlantic General Hospital Corporation Family Medicine Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

3100 N Tenaya Way
#B
Las Vegas, NV 89128

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 724-8877

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: jnovero119319@westdirect.optum.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1376502880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY",
            "address_2": "SUITE 555",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280443",
            "telephone_number": "702-685-8392",
            "fax_number": "702-475-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY",
            "address_2": "SUITE 555",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280443",
            "telephone_number": "702-685-8392",
            "fax_number": "702-475-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVERO",
        "first_name": "JIMMY JOHN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "12848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376502880",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.