Individual provider Active NPI

Makena Martin, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1417810359
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8724 Scalpay St
Las Vegas, NV 89166-6737
Phone
(702) 271-7914
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8724 Scalpay St
Las Vegas, NV 89166-6737

Mailing address

8724 Scalpay St
Las Vegas, NV 89166-6737

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223002538 NV Practitioner - Physician Assistant 7113408683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians

Practice addresses (Care Compare)

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (866) 722-1655

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (866) 722-1655

6675 S Cimarron Rd
Las Vegas, NV 89113-2132
Phone (702) 759-8600

7130 Smoke Ranch Rd
Las Vegas, NV 89128-3157
Phone (866) 722-1655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Bandt Birkin Kollins & Wong PLLC CurrentSince Aug 15, 2020 Accepting new patients
Radiology Specialists LTD Marasso-Miller CurrentSince Feb 9, 2026 Accepting new patients
Shelin Agrawal and Hyer PLLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

6675 S Cimarron Rd
Las Vegas, NV 89113

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": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1417810359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8724 SCALPAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8724 SCALPAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666737",
            "telephone_number": "702-271-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MAKENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.