Individual provider Active NPI

Rommel De Vera, D.O.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1407383904
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2659 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 302
Las Vegas, NV 89118-1896
Phone
(702) 867-9339
Fax
(702) 640-5898
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X DO2659 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 302
Las Vegas, NV 89118-1896

Mailing address

2345 E Prater Way Ste 207
Sparks, NV 89434-9634
Phone (702) 867-9339

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
I20200611001883 NV Practitioner - Family Practice 3870863848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

1389 Galleria Dr
Suite 100
Henderson, NV 89014-6686
Phone (725) 333-8400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Medical Group LLC Single Specialty CurrentSince Aug 3, 2020 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
South Hills Gastroenterology LLP Single Specialty Past Accepting new patients
University Medical Center of Southern Nevada Single Specialty Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

5380 S Rainbow Blvd
Ste 302
Las Vegas, NV 89118

5320 S Rainbow Blvd
Ste 302
Las Vegas, NV 89118
Phone (702) 382-8222

5380 S Rainbow Blvd
Ste 110
Las Vegas, NV 89118
Phone (702) 382-6100

5380 S Rainbow Blvd
Ste 330
Las Vegas, NV 89118
Phone (702) 382-8222

2345 E Prater Way
Ste 207
Sparks, NV 89434
Phone (775) 352-5301

Organizations & group practices 7

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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1407383904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E PRATER WAY STE 207",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349634",
            "telephone_number": "702-867-9339",
            "fax_number": "702-640-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181896",
            "telephone_number": "702-867-9339",
            "fax_number": "702-640-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "ROMMEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.