NPIMap

Organization Active NPI

Porferia Montesclaros MD LLC

  • Psychiatry Physician
  • Henderson, NV
National Provider Identifier
1417154188
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
11575 Issued in NV
Legal business name
PORFERIA MONTESCLAROS MD LLC
Practice address
2920 N Green Valley Pkwy
BLDG 3 Suite 312
Henderson, NV 89014-0406
Phone
(702) 253-1173
Fax
(702) 253-1468
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Porferia D Montesclaros, MDNPI 1609810068
Title
Owner
Phone
(702) 253-1173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 11575 NV Primary

Addresses

Primary practice location

2920 N Green Valley Pkwy
BLDG 3 Suite 312
Henderson, NV 89014-0406

Mailing address

2920 N Green Valley Pkwy
BLDG 3 Suite 312
Henderson, NV 89014-0406
Phone (702) 253-1173

National Provider Directory

National Provider Directory

Locations

2920 N Green Valley Pkwy
Ste 312
Henderson, NV 89014
Phone (702) 253-1173

6450 Spring Mountain Rd
Ste 8
Las Vegas, NV 89146
Phone (702) 382-7878

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417154188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N GREEN VALLEY PKWY",
            "address_2": "BLDG 3 SUITE 312",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140406",
            "telephone_number": "702-253-1173",
            "fax_number": "702-253-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N GREEN VALLEY PKWY",
            "address_2": "BLDG 3 SUITE 312",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140406",
            "telephone_number": "702-253-1173",
            "fax_number": "702-253-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORFERIA MONTESCLAROS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTESCLAROS",
        "authorized_official_first_name": "PORFERIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-253-1173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "11575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.