Individual provider Active NPI

Lloyd R Jensen, M.D.

  • Hospitalist Physician
  • Las Vegas, NV
National Provider Identifier
1407858418
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
16964 Issued in NV
Practice address
3186 S Maryland Pkwy
Sunrise Childrens Hospital Nicu
Las Vegas, NV 89169
Phone
(702) 731-8240
Fax
(702) 693-5331
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 16964 NV Primary

Addresses

Primary practice location

3186 S Maryland Pkwy
Sunrise Childrens Hospital Nicu
Las Vegas, NV 89169

Mailing address

3131 Lacanada St
Suite 244
Las Vegas, NV 89169
Phone (702) 697-0082

Other identifiers 1

IdentifierTypeStateIssuer
003760900MedicaidID

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
I20170822004111 NV Practitioner - Pediatric Medicine 4183804529 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16964NVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Pocatello Children's Clinic Past Accepting new patients

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407858418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 LACANADA ST",
            "address_2": "SUITE 244",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89169",
            "telephone_number": "702-697-0082",
            "fax_number": "702-691-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "address_2": "SUNRISE CHILDRENS HOSPITAL NICU",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89169",
            "telephone_number": "702-731-8240",
            "fax_number": "702-693-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LLOYD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "16964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003760900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.