Individual provider Active NPI

Praveen Saran, M.D., MPH

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1407077803
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9683 Issued in NV
Practice address
7010 Smoke Ranch Rd
Ste. 120
Las Vegas, NV 89128-3123
Phone
(702) 633-6006
Fax
(702) 633-9110
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9683 NV Primary

Addresses

Primary practice location

7010 Smoke Ranch Rd
Ste. 120
Las Vegas, NV 89128-3123

Mailing address

7529 Belgian Lion St
Las Vegas, NV 89139-5302
Phone (702) 633-6006

Other identifiers 1

IdentifierTypeStateIssuer
002018136MedicaidNV

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
I20040519000153 NV Practitioner - Addiction MedicinePractitioner - Internal MedicinePractitioner - Preventive Medicine 3274524418 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Residential Services LLC CurrentSince Sep 18, 2019 Accepting new patients
Shivay Saran International Chartered Internal Medicine PastSince May 18, 2004 Accepting new patients
Lionheart Recovery Center, Inc. Past Accepting new patients

Locations

2121 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 382-7746

Organizations & group practices 3

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1407077803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7529 BELGIAN LION ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891395302",
            "telephone_number": "702-633-6006",
            "fax_number": "702-633-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 SMOKE RANCH RD",
            "address_2": "STE. 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283123",
            "telephone_number": "702-633-6006",
            "fax_number": "702-633-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAN",
        "first_name": "PRAVEEN",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018136",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.