Individual provider Active NPI

Kenneth J Mooney, M.D.

  • Pulmonary Disease Physician
  • Henderson, NV
National Provider Identifier
1396797973
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
12134 Issued in NV
Practice address
10001 S Eastern Ave Ste 203
Henderson, NV 89052-3908
Phone
(702) 616-5915
Fax
(702) 616-5905
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 12134 NV
Sleep Medicine (Internal Medicine) Physician 207RS0012X 12134 NV
Pulmonary Disease Physician 207RP1001X 12134 NV Primary

Addresses

Primary practice location

10001 S Eastern Ave Ste 203
Henderson, NV 89052-3908

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (024) 064-7866

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
I20070828000793 NV Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Other (Physician) 6800809898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Missouri, Kansas City, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical Group Nevada LLCGroup PAC ID 1254571896, 127 clinicians

Practice addresses (Care Compare)

10001 S Eastern Ave
Suite 101
Henderson, NV 89052-3908
Phone (702) 616-5870

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
63.87
Promoting interoperability
96
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12134NVMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health CurrentSince Sep 12, 2016 Accepting new patients
Dignity Health CurrentSince Sep 12, 2016 Accepting new patients
Nocturna Sleep Center, LLC CurrentSince Sep 1, 2013 Accepting new patients
Dignity Health Medical Group Nevada, LLC Family Medicine CurrentSince Apr 20, 2022 Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Allison Curtis Kingsley Meoz Michael & Sanchez PC Pulmonary Disease PastSince Jun 1, 2015 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

10001 S Eastern Ave
Ste 101
Henderson, NV 89052
Phone (702) 616-5870

10001 S Eastern Ave
Ste 203
Henderson, NV 89052
Phone (702) 616-5915

2865 Siena Heights Dr
Ste 131
Henderson, NV 89052
Phone (702) 616-6580

8689 W Charleston Blvd
Ste 105
Las Vegas, NV 89117
Phone (702) 304-5900

8280 W Warm Springs Rd
Las Vegas, NV 89113
Phone (702) 458-5099

Organizations & group practices 11

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1396797973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "024-064-7866",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 203",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-616-5915",
            "fax_number": "702-616-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NV",
            "license": "12134",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NV",
            "license": "12134",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NV",
            "license": "12134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.